83IDENTIFICATION OF FRAILTY IN HOSPITAL: A SURVEY OF CLINICIANS

Abstract

Background: National guidelines recommend all older people admitted to hospital are assessed for frailty. Despite numerous national campaigns, frailty remains underrecognised. To investigate this further, we performed a survey of clinicians at East Lancashire Hospitals NHS Trust. Sampling Methods: A short paper survey was developed by a collaborative working group. Survey domains included; personal understanding of frailty, identification of frailty, assessments for frailty, management of frailty and education. Surveys were distribution at local educational events over a 12-week period. Result(s): Fifty-six clinicians were surveyed; 31 junior doctors, 6 core medical trainees, 5 specialty trainees, 10 consultants and 4 non-stated. Responders were working under a variety of specialties, the largest being geriatric medicine (29%), surgery (19%), and acute medicine (11%). Most responders (52%) agreed with the statement 'I use the term frailty in my clinical practice, but am uncertain of its definition'. Only 13% of responding junior doctors agreed they had been trained to identify frailty, compared to 40% of specialty trainees and consultants. Only 23% of junior doctors felt confident identifying frailty, yet 48% reported the presence/absence of frailty affected their clinical decision-making. Whilst 80% of responders felt all older people admitted to hospital should be assessed for frailty, only 41% agreed this was feasible. Only 25% agreed it was feasible for all patients identified as frail to be reviewed by a geriatrician. The vast majority of responders (89%) agreed more training was required. Conclusion(s): This survey demonstrates multiple target areas for improving the identification and management of frailty in hospital. We suspect our findings are indicative of difficulties at a national level. Responders have highlighted a lack of training, especially junior staff. An integrated training programme, as well as investment in developing systems to support the application of knowledge and skills may help to improve compliance with national guidelines.