Emergency department waiting times and the length of time people are in hospital are coming down at Dumfries and Galloway Royal Infirmary – a sign that new approaches to treatment are starting to work.
The board of NHS Dumfries and Galloway heard at its meeting on 11 August that DGRI’s emergency department waiting times, length of stay and readmission rates had all fallen. More emergency patients are being seen and either admitted, discharged or transferred within four hours than at any time in the last two years – despite the department being busier than ever. Much of this improvement has been credited to the new Acute Frailty Unit which opened in April this year.
Director of strategic planning and transformation David Rowland said: “Even though it’s been open only a few months, we can already see the effect the Frailty Unit is having on patient flow all the way through the hospital.
“By providing targeted specialist care to patients with frailty, starting as soon as they are admitted, the Unit helps them recover more quickly. That means they’re able to go home earlier – and that in turn allows us to admit and treat other patients more quickly. That’s one of the reasons why, even though more patients are coming into our Emergency Department, waiting times have gone down significantly.
“It’s also reducing the risk that a patient with frailty will have to come back into hospital after being treated and discharged. And that too is reducing the pressure on our Emergency Department and on the rest of the hospital.
“The Frailty Unit isn’t the only reason that we have been able to speed up treatment to this extent, but it is a big part of it, and we owe a huge amount to the team who have worked so hard to set it up. The challenge now is to build on their success and keep working towards the performance targets we have set ourselves.”
The Acute Frailty Unit, based in Ward D7, was introduced in response to the increasing health and social care needs of the region’s ageing population – one of the oldest in Scotland. Designed to provide rapid, person-centred care to older adults with frailty, the unit has helped reduce hospital stays, improved outcomes, prevented readmissions, and eased pressures on other parts of the hospital.
166 patients have been admitted to the unit, with 132 returning home directly – and with an average length of stay of just 3.4 days. That’s a significant improvement from the typical 17.5-day stay previously seen among older patients with frailty in the region.
82.1% of people who visited the DGRI Emergency Department in June were seen and either admitted, discharged or transferred within four hours – up from 73% before the Frailty Unit opened, and the best result in two years. And exceptionally long waits are now almost unheard of. Only nine people in June had to wait longer than 12 hours, compared with 110 a month earlier in the year.
In 2024 10.8% of people discharged from hospital were readmitted as emergencies within 28 days. After the Frailty Unit opened this year, that number dropped – to 9.5% in April and 7.8% in May.
Efforts to avoid delayed discharges are also paying off, the board heard. The Discharge Without Delay programme, brought in across the region, has reduced the number of delayed patients from 100 at the end of March this year to 85 in mid-July. Acquiring a second CT scanner for DGRI to prevent delays when one scanner is out of use for maintenance has also helped reduce both delays and length of stay.
And in mental health, a new triage system has successfully reduced waiting times in the Children’s and Adolescents Mental Health Service (CAMHS). 100% of young people referred to CAMHS now begin treatment within the target 18 weeks, and the overall waiting list for psychological therapies fell for the sixth month in a row to 709, compared with an average of 988 in 2023-4.