London and South East

Our Region Co-Chairs share an update every quarter, highlighting key developments, successes, and priorities from across their region.

We're seeking a committed and enthusiastic Co-Chair for the London and the South East region to support and strengthen our regional network. More information is available here. 

Winter pressures are felt across the London and South East region, which spans Gloucestershire, Oxfordshire and London through to Kent and Medway. Across the system, we see corridor care in ED, slow flow through hospitals, a lack of community beds, and difficult conversations with stressed patients, carers and families. Many of these discussions centre on how suboptimal the first few days of care have been, and how this has impacted the rest of a patient’s admission.

The first 72-hours standards, The Model Acute Pathway, were published by NHS England in partnership with the BGS a few weeks ago, with specific focus points for older people living with frailty. In recognition of this work, we are spotlighting Barnet Hospital, a district general hospital in North London, and its new Frailty Unit.

In January 2026, a dedicated Frailty Service assessment area, the Frailty Unit, was created to expand the geriatric medicine MDT and comprehensive geriatric assessments (CGAs) at the hospital front door. A key change that enabled this was the bold decision to hand over an existing inpatient geriatric medicine ward to another specialty, allowing the workforce to shift towards earlier assessment and intervention.

Despite older people with frailty being at highest risk of hospital admission-associated harm, they are often excluded from ambulatory pathways in Same Day Emergency Care. The new trolleyed Frailty Unit has helped address this by supporting bedbound and minimally mobile patients, proactively pulling patients from ED, accepting direct conveyance from the community, and working with the Ambulance Service SDEC pathway. It also supports the principles outlined in the 72-hour standards: early senior decision-making, patient and carer involvement, and care in the right place at the right time.

Initial data highlight its early success. Following the opening of the Frailty Unit, Barnet’s Frailty Service increased assessments from 52 patients in December 2025 to 96 in January 2026 and 161 in February 2026. The proportion of patients seen in an appropriate assessment area rose from 23% in December to 75% in January and 94% in February. The unit has remained unbedded since opening – a challenge faced by many similar services.

Same-day discharge rates have increased to 64%, while 40% of patients are now referred to admission-avoidance services, including Hospital at Home. The average patient age remains 86 years, with an average Clinical Frailty Scale score of 6.

Geriatricians have been central to driving this change through collaborative work across the MDT, from the early stages of service design to delivery. The Barnet team has seen every role contribute to service development, embracing new ways of working and adapting dynamically to change. The ultimate goal remains to improve quality, safety and patient experience while keeping patients at the heart of care despite ongoing pressures.