Transforming Weekend Flow: The Impact of a 7-Day Acute Frailty Service on Older Patients

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A Urquhart1; J Acharya1; A Manzoor2; A Lingeswaran2; A Aranda-Martinez2; K Yeong2; P Enwere2; C Chikusu2; R Williams2; R Lisk1
1. Ashford and St Peter’s Hospital NHS Trust; 2. Senior Adult Medical Service
Clinical Quality
CQ - Efficiency and Value for Money

Abstract

Introduction

The UK population is ageing, resulting in increasing numbers of older patients being admitted to hospital. At St Peter’s Hospital, Summary Acute Medicine Indicator Table (SAMIT) data show that frail patients aged over 75 have an average length of stay of 10.5 days. This group is particularly vulnerable to hospital-acquired harms, including infection, falls, and delirium, making early assessment and discharge a key priority.

Method

This quality improvement project utilised Plan–Do–Study–Act (PDSA) cycles to assess discharge rates for patients aged over 75 admitted via the acute medical take. Baseline data showed a marked reduction in 24-hour discharge rates at weekends compared with weekdays (9.1% vs 30.9%, October–December 2024).

The intervention introduced a weekend acute frailty service operating from 08:00 to 16:00 in the Older Persons Assessment Unit. The multidisciplinary team included a consultant geriatrician, a frailty physician associate, two nurses, and a healthcare assistant. Following a successful pilot period (January–February 2025), the service was relaunched on a permanent basis in October 2025. Data from October–December 2025 were used for analysis. The service aimed to rapidly assess, treat, and safely discharge patients aged over 75, with early involvement of community teams to prevent prolonged hospital admission.

Results

During the intervention period, there were on average 28 additional weekend discharges per month compared with the same months in 2024 (27.8% vs 8.5% of the acute medical take). This equates to an estimated saving of 3,570 bed days annually. After accounting for reduced bed days and staffing costs, this resulted in an estimated annual net saving of £1,266,394.

Conclusion

The introduction of a 7-day acute frailty service significantly improved weekend discharge rates for older patients, reducing unnecessary admissions and improving patient flow and resilience across urgent and emergency care services.


 

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