New advance care planning interventions to be developed by BGS/Dunhill Doctoral Training Fellow

24 November 2020

Dr Sarah Hopkins has been awarded the second joint British Geriatrics Society/Dunhill Medical Trust Doctoral Training Fellowship to support her PhD, ‘Using experience-based co-design to improve the impact of advance care planning on the quality of life and care of frail older people’. Sarah is a Cambridge Clinical Research Fellow and a Specialty Registrar in Geriatric and General Internal Medicine. Her research will be undertaken at University of Cambridge’s Department of Public Health and Primary Care.

As part of Sarah’s doctorate, she will examine how advance care planning (ACP) with older people living with frailty is managed and experienced during and after hospital inpatient care, including during the COVID-19 pandemic. Her research will also explore the outcomes that matter to these patients and their carers, and if and how ACP can help achieve these. She will work with frail older people, their carers and clinicians to use this evidence to co-design an intervention to improve ACP practice during and/or following hospitalisation, iteratively optimise the intervention, and design a future feasibility trial.

The Selection Committee found Sarah’s application to be highly relevant to improving older people’s healthcare and based on strong existing evidence that ACP in hospital is beneficial for older patients and their carers and that patients are receptive to such discussions1. Despite the recognised benefits, less than 5% of hospitalised older patients and less than 30% of all older patients with frailty participate2. To date, patients, carers and clinicians have not been involved in understanding and addressing this discrepancy3. In the UK, 82% of older patients have a hospital admission in the last year of life4. Sarah’s area of research therefore represents a real opportunity to improve outcomes for these patients through optimising discussions about values and preferences for future care. In addition, her findings will be an invaluable contribution to the evidence base for using experience-based co-design (EBCD) for intervention development with older individuals living with frailty.

Sarah is the second recipient of the BGS/Dunhill Medical Trust Doctoral Training Fellowship, which is a joint initiative to support research relevant to age-related diseases and frailty. The Fellowship will fund her PhD research over three years. One further Doctoral Training Fellowship will be awarded next year.

Sarah Hopkins, recipient of the Doctoral Training Fellowship, commented:

I am delighted to be funded by the British Geriatrics Society and Dunhill Medical Trust to collaborate with frail older people, their carers and clinicians to co-design a new approach to advance care planning. By working together, I hope we can meet the needs and priorities of frail older individuals and their loved ones. Thank you so much for making this research possible."

Susan Kay, Executive Director of the Dunhill Medical Trust, commented:

It’s been a pleasure to work with the British Geriatrics Society once again and have the opportunity to support this very relevant and timely piece of work by a promising early career researcher and excellent ambassador for the specialty.”


The call for the third round of applications will open in April 2021 with a deadline of 31 July 2021. Shortlisted candidates will be interviewed in October 2021. Applicants must be a Member of the British Geriatrics Society for the lifetime of the grant and meet the requirements for a programme of PhD study at a UK-based University. The grant covers salary, tuition fees, and consumables. Find out more at the Dunhill Medical Trust website.

1. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial, Detering et al, 2010
2. Reassessing advance care planning in the light of covid-19,  Hopkins et al, 2020
3. Reassessing advance care planning in the light of covid-19,  Hopkins et al, 2020
4. Health-services utilisation amongst older persons during the last year of life: a population-based study, Ní Chróinín et al, 2018