The Clinical Frailty Score as a Tool to Prioritise Ortho-Geriatric Resources: A Retrospective Audit in Aberdeen Royal Infirmary

Introduction

With an ever-growing frail population, the workload on ortho-geriatric services continues to increase and strategies to prioritise these resources must be identified. Within Aberdeen Royal Infirmary (ARI), the service predominantly comprises a team of ANPs with liaison consultant cover. The department was recently selected for a trial of an increase to daily consultant cover, with Clinical Frailty Scores (CFS) utilised as the triage tool for highlighting those with the highest frailty for increased and early senior medical input.

Method

Data from a two-week period in December 2025 was collected for people aged >/=75 admitted to the orthopaedic trauma unit. This information included CFS, diagnosis, evidence of delirium, length of stay and the team member predominantly involved in their care. Following the change, data with the same inclusion criteria was collected for a two-week period in March 2026 and both sets analysed retrospectively.

Results

33% of individuals with CFS of 1-3 and up to 50% of those with a CFS of 6 or more experienced delirium. In December, patients identified as a CFS of 1-3 remained in ARI for an average of 11.56 days and those with a CFS of 6-7 for 18.33 days. Following the test of change, the average length of stay was reduced across all bandings, including a significant reduction to 13.85 days for those banded CFS 6-7.

Conclusion(s)

CFS allowed for early identification of the frailest people admitted to the department. The redistribution of pre-existing resources, as well increased consultant time, allowed for senior review of individuals with the highest clinical need, whilst continuing to support ANP-led review. The results show that this model of resource allocation promoted shorter inpatient stays across the patient population. Future quality improvement work to support incorporation of CFS assessment into standard practice for admitting teams may streamline the service further.