Local NHS partnership to help vulnerable Derbyshire patients access faster urgent care
As part of our ambition to support patients to get the right care, at the right time, in the right place, University Hospitals of Derby and Burton (UHDB) is working with partner organisations to deliver more personalised care for elderly and frail patients who need urgent and emergency care.
We are working with East Midlands Ambulance Service NHS Trust and NHS 111 to help reduce long waiting times in our Emergency Department (ED) for older and vulnerable patients while improving their access to timely care and treatment.
Since September 2025, ambulance crews and NHS 111 call advisors can directly refer frail patients that are at-risk of further health decline to UHDB's Frailty Same Day Emergency Care Service (fSDEC) to access faster urgent care when it is expected they will not require a hospital stay, helping patients to get treated and go home sooner.
By referring directly, frail patients that fit the criteria to receive care at the fSDEC service can be assessed in a suitable environment away from busy waiting areas in ED, where they would otherwise be waiting a long time to be seen and treated - potentially causing further health complications.
"With this new partnership, we can take a whole system approach to delivering the same exceptional care to more of our community" - Jo Pattinson, Consultant
'Frailty' is used to describe vulnerable, usually older people who are at risk of their health seriously declining because of complex and several medical conditions they currently have or have had in the past.
The Frailty Same Day Emergency Care service at Royal Derby Hospital was set up in 2023 to provide older and vulnerable patients with complex medical needs with same day access to urgent care by a multi-disciplinary team - a service with multiple clinical specialties including consultants, clinical nurse specialists, advanced clinical practitioners, physiotherapists, occupational therapists and more. This dedicated unit is specialised in providing care to frail and medically complex patients and works together to provide a holistic care plan that is personalised to each patient.
To support more patients to be able to access the service as quickly as possible, from September 2025, partner organisations like NHS 111 and ambulance crews are now able to refer patients directly, where previously patients often had to go to the Emergency Department first.
Department of Medicine for the Elderly (DME) Consultant, Jo Pattinson, commented, "Our frail patients are at risk of the most adverse outcomes, so timely care and fast access to the right treatment, care team and space is incredibly important. The fSDEC was set up to address rising demands in needs for our frail patients and deliver rapid response care to those that would usually wait longer to be seen in busy Emergency Departments."
She explained that "with this new partnership, we can take a whole system approach to delivering the same exceptional care to more of our community - ensure that our partners are assessing patients that are suitable to get direct access to our frailty service, bypassing ED in some cases entirely. Alongside reducing pressure at our front door, we know that this is a much better experience for our patients - who may already be anxious, helping them wait and be seen in a comfortable environment, with a specialist team at hand."
Data has shown that there have been 300% more attendances at Frailty SDEC between 2023 and 2024. Despite the increase in demand, hospital admissions for fSDEC patients have reduced to 25% and of those who are admitted, patients stay in hospital on average two and a half days less.
Sabia Hussain, NHS 111 and 999 Integration Director for DHU Healthcare and East Midlands Ambulance Service, commented, "We know that nationally our older and frail patients are frequently visiting Emergency Departments for falls, minor infections, adverse reactions to medication and more - this accounts for almost 4,000 daily admissions across the country.
"Long wait times in ambulance and ED waiting rooms is not typically the best place for these patients, who are at greater risk of their health seriously declining quite quickly and increasing their risk of hospital admission and a longer length of stay. We knew there were real opportunities locally to work more cohesively as a system to deliver faster urgent care to patients at the right time and place."
This partnership relieves pressure on hospital front doors, allowing frontline teams to focus resources on those most in need of emergency intervention .
By streamlining patient flow and reducing unnecessary admissions, the initiative strengthens system resilience and supports the wider community with more efficient, effective care.
Sabia added, "This partnership between DHU Healthcare (NHS 111), East Midlands Ambulance Service NHS Trust and University Hospitals of Derby and Burton means we can offer a rapid assessment by a multi-specialist team, improve the time to access treatment and discharge patients much sooner than they would otherwise.
"Diverting patients away from the hospital front doors will alleviate pressures during periods of high demand for urgent care, for example during winter - it also means, most importantly, we are delivering fast and high quality patient-centred care that is making a difference to our communities."
CEO recognises exemplary team that is delivering same-day care faster to our vulnerable and older population
In recognition of their ongoing work to improve the care we offer to patients with frailty, the team were awarded a Monthly Making a Difference Award from Chief Executive, Stephen Posey.
Stephen said: " Colleagues have worked innovatively to embed this new service which is already having a significant impact in transforming the experience of our patients with frailty who need urgent care.
"Patient experience is at the heart of these changes and I am pleased to see this work is helping our patients to get seen earlier, improving how long they stay with us and getting them home safely, whilst avoiding an unnecessary hospital admission.
"This team is showcasing Always Improving in action, delivering better quality, safer care for some of our most vulnerable patients."