Frailty SDEC: Unlocking Bed Capacity and Ending Corridor Care

Introduction

Frailty Same Day Emergency Care (FSDEC) is an approach designed to provide rapid assessment, diagnosis, and treatment for older adults with frailty without requiring hospital admission. By reducing unnecessary inpatient stays, Frailty SDEC alleviates pressure on acute beds, improves patient flow, and enhances overall system efficiency. We explored the efficacy of this across 3 acute hospitals.

Method

A retrospective review of FSDEC activity was conducted from June 2024 for 1 year, across three sites in Surrey Heartlands ICS: ASPH, RSCH, and SaSH (which launched its service in October 2024 and data extrapolated). Frailty leads collaborated to ensure alignment on admission avoidance as the core principle with core data set and acceptance criteria. An audit in one acute setting indicated a 75% admission avoidance rate, which was agreed upon and applied to estimate bed-day savings.

Results

The three trusts have different sizes to their SDECs (6-9 chairs/trolleys), and the number of patients that they see was different (ASPH 2029, SaSH 1644, RSCH 1476). The average length of stay (LOS) on the national SAMIT-75 audit also varies (from 10.5 to 13.2 days).

This data was used for each trust as a LOS for admissions based on 75% admission avoidance. From this bed day savings were calculated across the ICS. All units saved 32 beds annually. Extrapolation to a 7-day service would increase this to around 45 beds per trust.

Across the ICS, 5,149 patients were managed through FSDEC, saving an estimated 34,934 bed days.

Expanding to seven days could increase savings to 48,908 bed days(134 beds). Doubling estate capacity could deliver 97,816 bed days - freeing 268 beds.

Conclusion

Investment in seven-day Frailty SDEC services and estate expansion is essential. Scaling this model may unlock bed capacity, reduce overcrowding, and improve patient experience—critical for modern urgent and emergency care systems.