Agenda item

Frailty Pathway

Presentation will be given by David Evans on the night.


Kathryn Magson presented item and slides.


Kathryn explained that Managing Frailty was how we describe caring for an ageing population. It is a clinically recognised state of increased vulnerability, and that there are different growth rates around the country but ultimately there is expected to be a 70 percent increase before 2035.A frailty index helps predict outcomes for all the patients.


Kathryn Magson said that the Rockwood tool is in use, it is a national tool and it pops up on the GP’s screen and on inputting some characteristics it can give a reading on whether the patient is severe or moderately frail.


Cllr Birnie asked how long Rockwood has been in use.


Trevor Fernandes explained that EFI Elderly Frailty Index triggers a number of services.  Rockwood has been in use for the last few months it is used to score the patient in General Practise and in Hospital and you can see how far from the normal score they are and work towards getting them back to it.


Cllr Birnie asked if Rockwood would become a more objective tool and would it become country wide.


Trevor Fernandes replied that that was the aim. They are trying to prevent people going to hospital and be more open about their problems that is a message that needs to go to the public.


Cllr Maddern added that she understood that patients are sometimes not found until they are in crisis, with data protection etc, how can we, the public, help?


Trevor Fernandes said that it would be good to try and persuade them to come along and that although discussions cannot be had with anyone else, notes could be put on the system as information can be taken in, even when it could not be given out.


Cllr Taylor said that he had someone referred to him and they went through the vulnerable adult path and gave all the details and that helped.


Cllr Hicks asked that when people were actually moved to care, how close to public transport would this be to enable the family to visit.


Kathryn Magson replied that the initial time is usual a maximum of 90 days, if the person then goes to residential care the decision would be made with the family.





Cllr Hicks made the point that visitors need access so that the patients don’t go downhill –and asked how close to public transport are all the step down beds and is there a maximum public transport time from where they live to where they are being treated.


Kathryn Magson replied that it was almost impossible to answer that as most people only have a short pathway with step down beds, ideally they then go home with care at home but if they need to go on to residential care it would be part of the decision process and would involve the family.


Trevor Fernandes explained that the voluntary sector offer transport help and Cllr Taylor added that Community Action Dacorum has a good system.


E Glatter asked where the 97 Beds are situated, and also are there postural stability classes available in Dacorum.


Kathryn Magson replied that there are beds in Langley Unit, Potters Bar etc., Holywell St Albans we have patients in Queensway, Brunswick in Watford St Peters and Simpsons Hemel Hempstead.  There are postural classes running at present, Herts Help has details.


Cllr Guest  asked if Kathryn would please ensure that they are promoted as widely as possible.


Kathryn Magson replied that information will be widely available and it will be put in Horizon, it is also promoted through most, if not all GP surgeries, and they certainly all have access to the information.


Trevor Fernandes went onto explain that these classes are available by referral from a GP for those at high risk and sometimes there are classes run through a surgery for those at medium or low risk but there is a lot out there through Community Centres and the Voluntary Sector which can be accessed by people directly.


There was a discussion around Prevention Strategy and Kathryn confirmed that although under the umbrella of County, District Councils also offer this service and it had been found to be most effective at local level.


Kevin Minier asked what a geriatrician was and Kathryn replied that it was a consultant in elderly care .Dr Fernandez explained that they are looking to recruit 2 more in this post to get care out to the community.


There was a discussion regarding stroke beds.  Cllr England asked where the16 stroke beds are situated and Kathryn said they are in Holywell. Cllr Hicks asked about age of people living in different areas and Trevor Fernandes said that Public Health would have that information and that health-wise they do look where they may have to tailor services.