Meeting the needs of an ageing society is one of the Governments’ ‘Grand Challenges.’ In coastal West Sussex, 25% of the population are over 65, a statistic England overall is projected to reflect by 2035. Emergency departments (EDs) have experienced increased attendances of older people and delivery of high quality, holistic care requires accurate screening and identification of frailty to enable personalised interventions. The clinical frailty scale is a pragmatic tool used to screen and identify frailty and at WSHFT has been used electronically both in the ED by triage nurses and by the admitting clinical team. 

In a project involving Will Shrier one of the ED core trainees, ED Consultant Colin Dewar and David Hunt we assessed the inter-rate reliability of 8,568 ED triage CFS assessments, finding a significant difference with the admission assessment and published the work in the EMJ: doi:10.1136/ emermed-2019-208633. The next step is to explore why this difference exists and what steps can be made to ‘close the gap.’ On the wards we are now systematically collecting electronic self-assessment of frailty to provide further understanding of an individuals’ status. We are collaborating with local universities and one of our research nurses has commenced a PhD in the area.