Older patients at the Leicester Royal Infirmary are getting faster, safer care thanks to a pioneering same-day unit that’s helping most avoid unnecessary hospital stays — and relieving strain on one of the country’s busiest emergency departments.
Since opening in January 2025, the Frailty Same Day Emergency Care (FSDEC) unit has helped more than 70% of patients get assessed, treated and safely discharged on the same day — delivering faster, joined-up care while helping more people avoid unnecessary hospital stays.
The unit was set up to provide rapid, specialist, multidisciplinary care to older people living with frailty, who are not well, who would otherwise face lengthy waits. The aim was simple: to appropriately assess, treat, and discharge on the same day, avoiding the harms of prolonged Emergency Department (ED) stays and unnecessary admissions.
The unit takes referrals directly from the ED as well as from GPs in the community. Prior to the unit being in place, it is likely that all patients would have been admitted.
Consultant Geriatrician and Associate Medical Director for Frailty at UHL, Chris Miller, explained how the new service benefits patients. He said: “The patients get to be seen by a specialist team, which includes consultant geriatricians, specialist pharmacists, advanced care practitioners, resident doctors, frailty trained nursing staff, physiotherapists, and occupational therapy colleagues.
“This has a massive benefit to patients, because we can understand their preferences of care, we can initiate medical, nursing and therapy services, and make onward referral to community services to manage these patients effectively and appropriately in their own homes, which is where most of them would like to be.”
And patients are delighted with the care they are receiving, describing it as “brilliant, joined-up care”.
Clive Williams, 77, was transferred to the Frailty SDEC from the ED after finding himself unable to move with back pain at home. The retired ambulance service worker said: “They have the right kit, they have the time to talk to you, they have the knowhow to treat you. Everyone, from the people who bring you food and help you shower, to the doctors, has been so professional.
“It’s brilliant, joined-up care. Everything has come together with my problems, and I’m really pleased to be part of a unit which, although it’s young, has taken off very well from what I can see around me. I have no complaints at all. They’re now trying to find me a community bed at Oakham, and in a way, I hope they don’t!”
Ann Alexander came to the unit to visit her sister, who was brought by ambulance into the ED after a fall at home. She said: “I know just how busy the hospital is and I was imagining spending hours in A&E with people on beds in corridors, and then when I was told my sister was here, I didn’t know what to expect. It’s beautiful: sliding doors which are easy to manage, privacy, specialist staff, clean, and modern. It’s brilliant that they recognise people, especially older people, just want to be back at home. It is fantastic.”
Brian Haines, 70, who has type-1 diabetes, was admitted with “blood sugars all over the place”.
He said: “The staff are amazing. It’s a good little unit and nobody sits in judgement. They are amazing people, from the consultants to the health care assistants, they are ever so good, and that’s my experience of it.”
Since the unit opened, 71% of the patients referred to F-SDEC have been discharged within 24 hours, preventing unnecessary hospital admissions.