WESTON GENERAL’S A&E FRAILTY TEAM BECOMES SOUTH WEST NHS AWARD WINNER BEATING ALL BIGGER HOSPITALS IN THE REGION

The Geriatric Emergency Medicine Service (GEMS) in A&E (Accident and Emergency) at Weston General Hospital has just become the south west regional winners for Urgent and Emergency Care in the NHS Parliamentary Awards – beating A&Es to win the accolade in larger hospitals from Bristol and Taunton down to Cornwall.

(Photograph, left to right: Kelly Knight – GEMS nurse, Wayne Bowman – GEMS Specialist Frailty Nurse, Dr Rachael Morris – Smith GEMS doctor and GEMS lead, Joe Middleton – GEMS Advanced Physiotherapist, Dr Rachael Mansi – GEMS doctor, Rachel O’Donnell – GEMS Pharmacist, Emma-Louise Woods – GEMS Administrator.)

GEMS is a new service developed over three years and launched in March of this year. It’s a holistic clinical service treating frail patients over 75. Run by a small multi-disciplinary team it cares for the patient and those who care for them.

Weston has one of the oldest populations coming through A&E compared to any hospital in the country. Out of a 241 hospital bed base, 30% of patients are aged over 80 and 60% of patients are aged over 65.

The frail elderly arrive at A&E with a multitude of complex issues and factors. It’s rarely ‘just a fall.’ Conventional A&E will conduct a raft of diagnostic tests that often result in frail elderly patients being admitted to hospital, in a deteriorating condition, unable to go home.

GEMS takes a holistic approach. In addition to a clinical assessment, GEMS looks at the patient’s home environment, medication, cognition – what brought them to A&E.

What is offered at Weston, which isn’t available elsewhere, is expert frailty care as soon as patients arrive in A&E, which can take up to two days on the wards.

The team is multi-disciplinary, consisting of two acute frailty doctors, two frailty speciality nurses, an advanced physiotherapist, a pharmacist and an administrator.

The clinical lead for the service Dr Rachael Morris explains more.

“We are absolutely thrilled to win the award. Older people living with frailty are a vulnerable group with complex needs and we’re privileged to care for them.

“Patients arrive frightened and worried – often not about their health but over things like who’s looking after the dog. They may have missed a meal and are parched. Our first question is do they want a cup of tea. We then sit and talk to them to understand their needs, conduct a full gold-standard, comprehensive geriatric assessment and decide ‘what next’ together – admitting into hospital if needed.

“The patient is always at the heart of what we do. We want them to be in control of their health. Alongside the patient and relatives, we plan for the future to maximise as good a quality of life as possible.

“If patients struggle to communicate we’ll phone family and carers to discover their wishes before they arrived in A&E. We talk to carers to see how they are coping. If they need support, we refer them to the carers’ support team.”

In addition to their work with patients in A&E, the team also supports junior doctors in A&E who have reported their confidence in dealing with the frail elderly has risen as a result.

The team runs training, open to all clinical and healthcare staff, teaching the specific clinical and associated needs of the frail and elderly to a variety of staff groups at Weston General Hospital.

James Rimmer, Chief Executive, Weston Area Health NHS Trust added his praise.

“We’re delighted that GEMS, based in our A&E department, has been recognised by an independent group of experts. It demonstrates that even with a temporary overnight closure Weston can provide innovative award-winning care.

“By looking at the needs of the whole person, and not just clinically, we’re able to offer a service that’s tailored to each patient. It means the hospital only admits patients that need our care. This is going to be especially important with an ageing population and increasing demands on the NHS in the future.”

The nomination was supported by local MP John Penrose. National judging takes place on Wednesday 10 July in the Houses of Parliament.