Implementing a Comprehensive Oncofrailty Service Across a Regional Cancer Centre: Early Outcomes from UHSussex 

 Title 
Implementing a Comprehensive Oncofrailty Service Across a Regional Cancer Centre: Early Outcomes from UHSussex 

Background 
The ageing population is driving a substantial increase in the number of older adults living with cancer. Frailty is associated with poorer treatment tolerance, increased healthcare utilisation and worse clinical outcomes. Comprehensive Geriatric Assessment (CGA) is recommended to support treatment decision-making and optimise outcomes for older people with cancer, yet access to dedicated oncofrailty services remains variable. In 2026, University Hospitals Sussex NHS Foundation Trust established a multidisciplinary Oncofrailty Service to support older adults being considered for systemic anti-cancer treatment (SACT), radiotherapy or other cancer therapies. 

Methods 
A multidisciplinary service was developed incorporating a consultant geriatrician, oncologist, occupational therapist and allied health professionals. Patients aged ≥65 years with cancer and evidence of frailty (Clinical Frailty Scale ≥3), or those meeting tumour-specific criteria, were referred from oncology and cancer nurse specialist teams. Patients underwent CGA with assessment of physiological reserve, multimorbidity, polypharmacy, cognition, mobility, function and advance care planning needs. Individualised management plans were communicated to patients, primary care and oncology teams. Service activity and outcomes were prospectively recorded during the first six weeks of operation. 

Results 
Fifty-one patients were referred within the first six weeks. Referrals were predominantly from consultant oncologists (29/51) and cancer nurse specialists (19/51), with the largest referral groups being lung cancer (21/51) and gynaecological malignancies (18/51). Twenty-one patients completed a CGA clinic assessment and six received allied health professional-led telephone interventions. 

Early clinical impact included recommendations to modify oncology treatment in 13 patients, completion of seven DNAR discussions and 21 advance care planning conversations. A total of 29 medications were deprescribed (mean 1.4 per patient assessed), Eight hospital admissions were avoided, and one chemotherapy treatment slot directly saved through optimisation of treatment planning. Patient feedback was overwhelmingly positive, highlighting the value of a holistic and person-centred approach. 

Conclusions 
A dedicated multidisciplinary Oncofrailty Service is feasible to implement within a regional cancer centre and demonstrates early benefits for treatment decision-making, polypharmacy reduction, advance care planning and hospital admission avoidance. These findings support the integration of geriatric expertise within cancer pathways and provide a foundation for further evaluation of patient outcomes, healthcare utilisation and cost-effectiveness