Majority of Hospitals Not Routinely Screening Older Patients for Frailty, Report Suggests

The study said one in five surgical patients over 60 have frailty, but many patients are unaware they have the condition or how it can impact their recovery.

A general view of staff on a NHS hospital ward at Ealing Hospital in London, on Jan. 18, 2023. Jeff Moore/PA Wire

Analysis led by the Royal College of Anaesthetists (RCoA) suggests that the majority of hospitals are not routinely screening older surgery patients for frailty, despite them being at greater risk for complications.

In its report published in the British Journal of Anaesthesia on Tuesday, researchers said that 71 percent of hospitals across the UK were not routinely screening patients over 60 who were scheduled for surgery.

This is based off data from 7,134 patients across 263 NHS hospitals collected over five consecutive days in March 2022.

Frailty is a medical condition affecting older adults that can lead to fatigue, weakness, and slower movement. It may also involve muscle loss and unintentional weight loss. Individuals with frailty may require assistance with daily activities.

The study, conducted in partnership with the University of Nottingham, said that one in five (19.6 percent) surgical patients over 60 have frailty, but many patients are unaware they have the condition or how it can impact their recovery.

Increased Risks

The report highlights the risks associated for surgical patients with frailty. These include staying in hospital on average three days longer, with that figure increasing to six days for those with more severe forms of the condition.

They were also three times more likely to have complications post-surgery, and four times more likely to have delirium, which is a condition causing confusion.

Patients with frailty were also three times more likely to die within one year of surgery.

Report authors noted that better screening can help health care professionals prepare individual treatment options and ensure patients have the right support, which improves recovery.

It also allows for doctors to have conversations with patients about the likelihood of survival and the chance of them regaining independence post operation.

Frailty can be detected with a straightforward tool called the Clinical Frailty Scale, and clinicians are calling for all surgical patients over 60 to be screened using it.

Implementing Effective Screening

Dr. Claire Shannon, president of the RCoA, highlighted that as the population ages, older people are accounting for an increasing proportion of surgical patients, so “implementing effective screening for frailty is becoming ever more necessary.”

“Universal adoption of frailty assessments will not only help patients recover better from surgery but also help improve efficiency by avoiding extended lengths of stay in hospital,” she said.

A general view of staff on a NHS hospital ward at Ealing Hospital in London, on Jan. 18, 2023. PA Wire/PA Images

Professor Iain Moppett from the School of Medicine at the University of Nottingham said that the study “highlighted just how common frailty is in older people having surgery.”

He added that screening, combined with good teamwork between the right specialists, such as surgeons, anaesthetists, and geriatricians, “helps to get patients living with frailty as fit and well as possible before surgery, making the right decisions and get the best care after surgery.”

Responding to the RCoA’s report, an NHS spokesperson told The Epoch Times: “Assessing frailty is essential in helping to get older patients as fit and well as possible before, during, and after surgery and the NHS elective care plan reinforces this.

“The NHS continues work to support efforts to change the way care is given to relieve the pressure on hospitals and adapt to the increasing demands of an ageing population.”

Elder Care in A&E

Older patients often have complex needs in health care settings, which can be worsened by difficulties in delivering timely and appropriate care.

This was highlighted by a recent report from the Royal College of Emergency Medicine (RCEM), which found that in 2024, more than 1.1 million people over 60 waited 12 hours or more in A&E before being admitted.

The RCEM said that for patients over the age of 75, there was insufficient screening in emergency rooms for common conditions that affect seniors, including for delirium, general frailty, or the risk of falling.

Speaking at the time, Secretary of State for Health and Social Care Wes Streeting said, “Anyone being stuck in A&E for that length of time is unacceptable, but for people who spent their lives paying into the NHS and giving to our country it is particularly appalling.”

The minister said that is why the government is working to improve the NHS, adding that since Labour came to power in July 2024, the government has cut NHS waiting lists and made available more than 2 million additional appointments.

The government is currently developing its 10 Year Health Plan, which among other endeavours aims to improve community health care, bolster the focus on preventative care, and integrate more technological solutions to patient recording keeping and access.

The Labour administration has also invested an extra £26 billion to reform the NHS, recruiting an extra 1,000 GPs, and pledging £102 million for refurbishments and building upgrades to GP surgeries, in order to create more space to see patients.