“All Hands On FSDEC”: Implementation of an MDT Delivered Same Day Emergency Care Unit for Older Patients Living with Frailty

Introduction

Older adults living with frailty are at high risk of harm in traditional emergency care settings whilst frailty prevalence is rising. The Frailty Same Day Emergency Care (FSDEC) service at University Hospitals of Leicester (UHL) was launched in January 2025 to provide rapid, specialist-led, multidisciplinary care outside the Emergency Department (ED) footprint. The aim: to assess, treat, and discharge patients on the same day, avoiding unnecessary and unwanted admissions and aligning with the NHS Long Term Plan.

Method

FSDEC operated as a three-month pilot within the medical SDEC, open daily 0900–1700. Patients were referred from ED, GPs, ambulance services, and community teams. A multidisciplinary team (MDT) — including geriatricians, ACPs, nurses, therapists, pharmacists, and care coordinators — delivered integrated, person-centered care.

Results

Between January and March 2025, 471 patients were seen, with 75.5% discharged. Alongside the Frailty Emergency Squad (FES; frailty in-reach team in ED), 835 discharges were achieved over 10 weeks, more than doubling previous rates. FSDEC improved ED flow and reduced inpatient bed days by approximately 573 per month. Staff reported improved satisfaction and decision-making. Despite challenges (e.g. space, IT, and social care delays), the service demonstrated feasibility and scalability using existing resources.

Conclusion(s)

FSDEC offers a replicable model for urgent frailty care that is proactive, integrated, and person-centered. It delivers better outcomes, faster care, and aligns with national priorities. Now adopted as a substantive service, considerations are in place to extend hours, improve IT, and deepen community integration. FSDEC is poised to become a cornerstone of urgent care for older people across Leicester, Leicestershire and Rutland.