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An 83-year-old man has become the very first patient at Warwickshire North’s pilot Frailty Hub Clinic. 

Gerald Spencer and his wife Nadine Spencer were met with an ovation from a range of health and social care staff as they entered the doors of Hazelwood Practice on Saturday, 23rd September.

The pilot Frailty Hub has been launched within Warwickshire Rural PCN to support patients in a more proactive way. It comes after a need was identified to better coordinate care for people with frailty who have complex needs due to multiple long-term conditions.

The hub is a collaborative approach between:

  • George Eliot Hospital
  • South Warwickshire University NHS Foundation Trust Out Of Hospital
  • Voluntary and community sector
  • Primary Care Network 
  • Warwickshire North Place

Dr Mehwish Qureshi, Clinical Director for Rural Warwickshire North PCN said: “Our first patient has been assessed today and we have had great feedback from him when he finished. There was no time pressure, he was able to discuss things and also left reassured that he has had a thorough assessment, and I think that is what we are trying to achieve here.” 

The ‘one stop shop’ hub will allow patients to see a range of specialists in a single visit. Research has shown that it can be difficult for frailty patients to attend the variety of appointments and different settings on a regular basis, particularly in more rural areas where transport options are limited.

Dr Mehwish added: “We identified an area of a gap within the service. We decided to bring all of our agencies and stakeholders together to start thinking about a one stop, multi-disciplinary run clinic for the patients, so that they are not going to multiple appointments to have their assessments.

“This is also an attempt to try and narrow the health inequalities gap in the area, this is quite a rural area and it often very difficult for patients to get to the hospital appointments or even sometimes the GP appointments as well.”

The hub will adopt a Population Health Management (PHM) way of working by using data to identify patients who may benefit from the Frailty Hub.  Over time, the hub will be using the frailty dashboard which is being developed as part of the system-wide roll-out of the PHM data platform – HealtheIntent.  

During their time at the clinic, patients will receive a personalised care plan that takes into account all of their health needs in one place. Any further interventions or support needed after their clinic visit will be coordinated to enable the care plan to be implemented.

Watch the video below to see the moment Gerald became the first patient at the Frailty Hub Clinic.