Acute Frailty Service

Why choose the Acute Frailty Assessment Unit?

Care of older people is a key priority at the PRUH. Along with the inpatient frailty short stay unit and inpatient wards, the new Acute Frailty Assessment Unit – comprising a bay of four trolleys, two side rooms, a recliner seated area for assessment/treatment, and a therapy assessment area – has been refurbished to incorporate ageing and dementia friendly principles into the environment.

The Acute Frailty Assessment Unit provides a dedicated area for frail patients to be assessed, treated and supported by skilled multidisciplinary teams delivering assessments and specialized care.

Why choose the PRUH?

The PRUH is a modern, acute hospital based in Locksbottom in the London borough of Bromley. It has a number of specialist services, including an established frailty unit and a hyper acute stroke unit.

With a strong sense of community and a focus on staff health and wellbeing, the PRUH is one of south-east London’s top healthcare employers. It has a range of health and wellbeing initiatives, spearheaded by a dedicated staff wellbeing team, which encompasses physical and psychological support.

In March 2021, the Trust won the HSJ Workforce Initiative of the Year Award for the support put in place for staff during the COVID-19 pandemic. The Staff Support and Wellbeing Program rapidly implemented a whole hospital staff wellbeing response, bringing together multiple disciplines to manage the impact of COVID-19 on its 14,000 staff and volunteers.

The Trust’s new strategy, Strong Roots, Global Reach, sets out a BOLD vision:

• Brilliant people
• Outstanding care for patients,
• Leaders in research, innovation and education
• Diversity, equality and inclusion at the heart of everything we do.

The Trust is a welcoming and inclusive place to work, with equality, diversity and inclusion at its heart. Additionally, the Trust has three staff networks: the Black, Asian and Minority Ethnic (BAME) network; the Lesbian, Gay, Bisexual, Trans (LGBT+) network; and the Disability Network. These networks embrace difference and celebrate the diversity of staff at the Trust.  

If your values align with the Trust’s vision, and you are ambitious, innovative, visionary, and passionate about shaping and delivering excellent specialized frailty service to frail older patients, then come join the Princess Royal University Hospital on the journey to world class.

Located just a few miles from both Bromley and Orrington, which have excellent shops, cafes, bars, schools and transport links to London, the PRUH is also ideally located for those who enjoy escaping the hustle and bustle. The Kent countryside is a short drive away.   

Acute Frailty Service

• Nurse Consultant Frailty & Clinical Gerontology

  Professional expertise and knowledge in frailty, dementia and geriatrics. Educated to Masters level and with a nurse prescribing qualification as essential, ability to work to a high degree of autonomy delivering specialist clinical care to patients with complex needs. Role will include developing and leading strategies for education, research, professional line management of CNS and ACP workforce

• Advanced Clinical Practitioners

  Advanced clinical practitioners from a variety of healthcare backgrounds (AHPs, therapists, nurses, pharmacists and paramedics) will undertake comprehensive specialist holistic assessments for individuals presenting with frailty within the acute care setting, with the purpose of creating an individualised agreed management plan; incorporating pharmacological considerations, long-term conditions management, frailty syndrome identification, prevention and management, diagnostic reasoning and initiating onward referral to specialist teams as appropriate. In alignment with our integrated frailty strategy, it is envisaged these posts will work in an integrated fashion including placement in the frailty rotation of the urgent community response team.

• Frailty Clinical Nurse Specialist

  Provide expert specialist nursing for patients with frailty, providing assessment of needs, advice and support to patients, their families and healthcare professionals. Education to the multi-professional team both internal and external stakeholders. Works in collaboration with our One Bromley community partners. Active participation in research & development. A key part of the role will involve working directly with the ED triage nurse and RAT Consultant to identify appropriate patients who can be pulled/ referred to the Acute Frailty Service.

• Dementia and Delirium CNS

  Provide expert specialist nursing for patients with dementia and/or delirium providing assessment of needs, advice and support to patients, their families and healthcare professionals. Works in collaboration with One Bromley partners to ensure continuity and seamless care for patients, including but not limited to Oxleas and Bromley Dementia Hub. Education across the multi-professional team to both internal and external stakeholders. Active participation in research & development.

• Frailty unit administrator

  To provide high quality administrative and clerical support to the acute frailty service. To be responsible for the management of patient information and to maintain accurate patient data on PIMS. Admitting and discharging patients on PIMS, arranging follow up appointments and investigations, booking transport. To provide a full and professional reception service (including telephone enquiries) for patients, visitors and staff, ensuring they are informed appropriately.

• Clinical administrator (for patient flow)

  To provide a quality administrative service that supports patient flow and the acute frailty service professionals involved in the assessment, admission and safe discharge of adult patients. Responsibilities including facilitation of diagnostics in a timely manner, chasing investigation results, supporting discharges/ liaising with Transfer of Care team.

• Frailty social worker

  Provision of high quality social work service to patients with frailty. Working as an integrated member of the multi-disciplinary acute frailty service.  The Social worker will support safe discharge and admission avoidance for patients by conducting assessments, advocacy and liaison with the multi-disciplinary teams across One Bromley network, liaison with the family and other parties. Referral as required to Local Authority Social Services or the voluntary sector. Aiming towards a trusted assessor model to expedite packages of care, placement etc. Advising/supporting on matters relating to safeguarding, capacity.

• Frailty third Sector Care Navigator & Family support

  Will attend Multi-Disciplinary Team Meetings (MDT) working alongside health and social care professionals. The Care Navigator will be pivotal in capturing the patient’s non-medical support needs and then navigating them to the right support, right place, at the right time. The Care Navigator will also sign post, enable access and/or refer to third sector services of benefit and provide information and encouragement to support patients to be empowered to make informed decisions about their health and wellbeing.  Liaise with Age UK Bromley & Greenwich’s volunteers who will support and encourage people to enable them to pursue their interests

• Specialist Frailty Physiotherapist

  Provide specialist, individualized, objective, clinical assessment of physical function, to inform, both current and ongoing treatment and management needs. To complete appropriate onward referrals and highlight relevant community support services. In line with the integrated frailty strategy.

• Specialist Frailty Occupational therapist

  Provide specialist holistic assessment of cognitive and physical function across all activities of daily living. OT’s assessment will, as part of an MDT assessment, help to identify cognitive impairment and the impact this has on the patients ability to complete daily living activities.   Occupational Therapists Identify need for rehabilitation, compensatory techniques or adaptations and equipment needs to maintain and promote independence. OT’s on the unit will facilitate timely discharge home or referrals to onward community partners via appropriate liaison, as required, with regard to onwards referrals to promote supportive discharge and admission avoidance.

• Speech and Language Therapist

  Provide timely assessment, treatment and management of individuals with communication and/or swallowing difficulties. Speech & Language Therapists will ensure that the person’s communication and/or swallowing skills and difficulties prior to admission to the unit are always used to inform the MDT management plan, including onward referral to community services as appropriate.

• Dietitian

  Provide dietetic assessment with a tailored plan to meet patient’s nutritional needs, including advice on high energy and protein diet, food fortification and oral nutritional supplements to help reduce malnutrition risk, attenuation of lean body mass and reduction of muscle atrophy. Utilization of anthropometrical techniques to monitor nutritional status. Delivery of care to optimize patient’s nutritional status which will potentially improve patient’s ability to mobilize and exercise, reducing the risk of falls and further admissions with onward referrals to community dietitians were required.

• Frailty Specialist Pharmacist

  Work within frailty MDT to ensure evidence based, cost effective prescribing, and patient centred medication review with the aim of optimising medications, reducing inappropriate polypharmacy and enhancing therapeutic outcomes for our patients. Liaise with primary care healthcare professionals, carers and relatives, to provide high specialist clinical advice to ensure safe and optimal administration of medication. Provide education and training to other members of the MDT on impact of newly prescribed medication and medications that commonly cause problems for patients living with frailty.

• Consultants – Frailty

  Clinical management of referrals and review of patients post assessment to determine appropriate admission or discharge pathway for patients. Providing hot clinics to support admission avoidance and early discharge. Clinical supervision of junior doctors and ACPs.

• Junior Clinical Fellow

  Medical cover for Acute frailty assessment unit, working as an integral part of the multidisciplinary team undertaking clinical assessment, completing investigations, initiating treatment plans and facilitating onward referral where required. JCF posts will rotate into the inpatient frailty and geriatric wards