Evaluation of a Newly Established Geriatric-Oncology Service at a London Teaching Hospital​

Introduction: Comprehensive Geriatric Assessment (CGA) in patients with cancer and frailty improves health-related quality of life, reduces toxicity and improves adherence to anti-cancer treatments. The Royal College of Physicians recommends that specialist Oncogeriatric services are developed to proactively provide multi-domain frailty assessment with management of frailty-related issues. At University College London Hospitals NHS Trust (UCH) a weekly, geriatrician-led multidisciplinary clinic was established in 2024 as part of the Geriatric-Oncology service. Initially, this was open to lung cancer patients only and later expanded to patients with any cancer type. This project aimed to evaluate patient characteristics, referral timeliness and interventions delivered within the clinic.

Method: Data were collected retrospectively from electronic patient records for all Geriatric-Oncology clinics conducted over 100 weeks (January 2024-December 2025).

Results: 335 appointments were booked, with 247 (73.7%) attended. Median age was 80 years (interquartile range, IQR, 75-84), median Clinical Frailty Scale was 4 and Performance Status was 2. The commonest cancer type was lung (n=68, 27.5%) followed by lymphoma (n=36, 14.6%). Similar numbers of patients had localised (n=99, 40.8%) and metastatic (n=93, 37.7%) disease. Chemotherapy was the commonest anti-cancer treatment (n=124, 50.2%) and 158 patients (64.0%) were already established on treatment. Median referral-to-appointment time was 17 days (IQR 13-31). Interventions were multi-domain, most commonly falls review (n=179, 72.5%), therapy input (n=150, 60.7%), psychology review (n=139, 56.3%) and polypharmacy review (n=132, 53.4%). Anti-cancer treatment changes were recommended for 11 (4.5%).

Conclusions: The UCH Geriatric-Oncology outpatient service has been successfully established: appropriate patients are referred, and CGA is performed within three weeks. Most patients are already established on anti-cancer treatment, likely reflecting clinical urgency. Interventions are multidimensional and multidisciplinary. Next steps include improving access across cancer types, reducing non-attendance, and evaluating service benefit through reviewing outcomes including treatment compliance, complications, unplanned hospital admissions and survival.