Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to encourage the (1) consistent, and (2) timely, provision of inpatient physiotherapy in acute district hospitals for older patients with frailty syndrome.

Getting It Right First Time (GIRFT), in conjunction with the British Geriatrics Society, published Six Steps to Better Care for Older People in Acute Hospitals, which accompanies the GIRFT hospital acute care frailty pathway. A copy of the document is attached.

The acute care pathway recommends that all older patients admitted to hospital as an emergency are assessed for their degree of frailty using a standardised assessment, namely the Clinical Frailty Scale. For patients identified as living with moderate or severe frailty, the pathway recommends a multidomain assessment, namely the Comprehensive Geriatric Assessment, and links this to functional optimisation, which would commonly include physiotherapy assessment supporting recovery or maintenance of mobility.

Ongoing support to patients to prevent hospital-acquired deconditioning should be supported by the whole ward team after physiotherapists have recommended appropriate intervention.

The Six Steps to Better Care guidance makes similar recommendations for older patients admitted to hospital for planned care. As part of GIRFT's ongoing review and support, implementation of these recommendations is reviewed at individual hospital trusts, including the staffing levels of older person multidisciplinary teams, which include physiotherapists.

In addition, GIRFT recommends the development of Advanced Care Practitioners (ACPs) specialising in frailty. Some trusts have development programmes to support training of ACPs, although there is variation in provision.