University Hospitals Morecambe Bay NHS Foundation Trust wanted to improve patient flow through the health and social care system.  The Trust received funding from NHS Improvement to enable the identification and implementation of a digital ‘front door’ for patient streaming at the Royal Lancaster Infirmary (RLI) Emergency Department to reduce inappropriate admissions and improve patient flow to community and social care services.

At the commencement of this project, patient streaming within the RLI was directed to an embedded GP within the Emergency Department.  While patient streaming was already part of the triage process, in practice, as few as one patient per session was being streamed in this way and the embedded GP often found themselves operating as an additional A&E resource.

Following research in the market and other patient flow projects underway, the Project Executive decided to look to develop and implement a Comprehensive Frailty Decision Tool and frailty care pathway to support the digital streaming of this cohort of patients.  Castlerigg Consulting was commissioned by the Chief Information Officer from Bay Health and Care Partners to deliver the Comprehensive Frailty Decision Tool into the RLI Emergency Department.