DEFINE(prehospital): A protocol for a qualitative interview study to determine the pathway and response to the inclusion of frailty in pre-hospital trauma triage tools

At the start of the COVID-19 pandemic South Western Ambulance Service Foundation Trust (SWASFT) changed its pre-hospital trauma triage tool to include an assessment of frailty, and if scored 5 or more on the Clinical Frailty Scale, the tool instructed the person to be conveyed to a trauma unit and not the major trauma centre. How the use of frailty has been operationalised and effected in daily clinical practice is unknown. There were concerns during the COVID-19 pandemic that care was being rationed by a frailty score alone, without expert oversight or appropriate training. Whether or not care rationing was appropriate at the height of the pandemic remains a philosophical question, however more research is needed into using the CFS for this type of decision making. This is relevant to using frailty scores in trauma triage tools outside of a pandemic situation, particularly when a score may prompt a change in clinical management. This study aims to explore the pathways of care that have been associated with this incorporation of frailty. In addition, it will aim to explore healthcare professionals experience of frailty scoring for trauma patients pre-hospital and at the receiving hospitals.