Frailty Services Expansion to Build on Improved Performance
The national roll-out of specialist frailty services at all 30 A&E departments will build on recent progress to clear long waits and help reduce hospital stay length for the most vulnerable people.
Frailty Units are specialist beds that focus on intense assessment of older people with frailty – the services offer access to specialist skills and care plans, accelerate early discharge and look to reduce delays and length of stay.
The expansion, supported through the £200 million announced as part of the 2025-26 Budget, will be a key focus of the Scottish Government’s new Operational Improvement Plan for the NHS, due to publish this Spring. This will include changes to the way acute services are delivered to help reduce waiting times. In recent weeks Health Boards have reported significant progress against long waits, including:
- the pledge to carry out 64,000 procedures through £30 million additional funding by the end of March 2025 has already been exceeded – with boards reporting to have 75,500 delivered by end of January 2025.
- a 4% decrease in the total waiting list size for diagnostics – with waits now at their lowest since October 2021
- a 12% decrease from a recent peak in April 2024 in total ongoing waits for eight key diagnostic tests combined
- 90.6% of Child and Adolescent Mental Health Services (CAMHS) referrals being seen within 18 weeks from October to December– the standard is 90%.
Health Secretary Neil Gray outlined the Scottish Government’s plans to build on this progress by installing a frailty service in every site with a core A&E by the summer.
Today @neilcgray met staff working in Glasgow Royal Infirmary's frailty service – the team have reported strong progress in the last 18 months with average length of stay for vulnerable patients reducing by 3 days, without any increase in readmissionhttps://t.co/YnEVHakQhb pic.twitter.com/FqGVS4fppI
— Scot Gov Health (@scotgovhealth) March 5, 2025
In recent weeks we have seen good progress in reducing waits and there are encouraging signs that our plan is working. However, we know there is more to do and we want to drive further improvement. That is why we are investing £200 million to help clear waiting list backlogs, improve capacity and reduce delayed discharge.
HEALTH SECRETARY NEIL GRAY
I was pleased to meet the team working in the Glasgow Royal Infirmary frailty service and see first-hand the positive impact their crucial work is having – with the service allowing speedier assessment of vulnerable people presenting at A&E and reducing length of stay for patients significantly.
We want to replicate this success across Scotland and shift the balance of care from acute, to community. Through a portion of our £200 million investment, we will deliver direct access to specialist frailty teams in every A&E by this summer. This will enable people who experience frailty to be referred directly by GPs and the Scottish Ambulance Service to specialist frailty services as an alternative to attending A&E or admission.
Background
There are currently five frailty units – these have been set up during the Focus on Frailty programme led by Health improvement Scotland across Ayrshire and Arran, Lanarkshire, Tayside, Glasgow and Dumfries and Galloway. There is variation in these services with no standard model. The services provide a dedicated closed unit or area staffed by frailty / medicine of the elderly staff with frailty assessment within the first hour of arrival at hospital.
In April 2024 the Scottish Government funded NHS boards to deliver 64,000 procedures (40,000 diagnostic procedures, 12,000 surgeries and 12,000 new outpatient appointments) by March 2025. By 31 January 2025, 56,500 diagnostic procedures, almost 9,200 surgeries, and over 9,800 outpatient appointments had been delivered.
