Posters

Introduction Frailty is a major predictor of adverse postoperative outcomes, yet routine identification within elective surgical pathways remains inconsistent. National perioperative guidance recommends early frailty identification to facilitate optimisation and shared decision-making, but sustainable implementation at scale has proved challenging. Swansea Bay University Health Board developed and evaluated a digital patient self-assessment pathway using a modified patient-reported Clinical Frailty Scale (CFS). Following a successful pilot in elective general surgery, the pathway was adopted

Introduction Fascia Iliaca (FI) nerve blocks are recommended for patients presenting with neck of femur fractures to provide effective analgesia and reduce opioid requirements. We conducted a quality improvement project (QIP) in a busy district general hospital to increase the proportion of patients receiving FI blocks and improve compliance with post-procedural safety precautions, in line with Royal College of Anaesthetists (RCoA) guidance. Methods Data were collected retrospectively from the local orthopaedic trauma database and electronic patient records over two separate two-week periods

Introduction Frailty is associated with increased rates of postoperative complications, a quarter of adults undergoing emergency laparotomy are living with frailty. The "Care of the Elderly Surgical Liaison service" aims to provide a comprehensive geriatric assessment for surgical patients aged over 65 years old and living with frailty. The aim was to conduct a general review of the Surgical Liaison service at Royal Bolton Hospital and improve the referral process. Method The project was a retrospective study across a period of 3 years, from January 2023 to December 2025. A total of 730

Title: Optimising Guideline-Based Laxative Prescribing in Older Adult Inpatients: A Quality Improvement Project Introduction: Constipation is common in older adult inpatients and is associated with delirium, urinary retention, abdominal discomfort, prolonged hospital stay and increased polypharmacy. Despite national guidance, laxatives are frequently prescribed without adequate assessment of reversible causes or documentation of the indication. We aimed to improve guideline-based, individualised laxative prescribing on two geriatric wards, targeting 85% appropriate management within 8–12 weeks

INTRODUCTION Frailty is common among older adults with atrial fibrillation (AF) and may influence anticoagulation prescribing despite not being incorporated into conventional stroke and bleeding risk assessment tools. Concerns regarding falls, bleeding risk and multimorbidity may contribute to therapeutic uncertainty. This study evaluated the association between frailty, anticoagulation use and clinical outcomes in older adults admitted with AF. METHODS A prospective observational study was conducted across four elderly care wards in a UK district general hospital. Consecutive inpatients aged

Background: Delirium is a common complication of hospitalisation in older adults and is associated with increased mortality, prolonged hospital stay and functional decline. Although routine screening using the 4AT is recommended, delirium assessment and documentation remain inconsistent. Baseline auditing identified poor ward-based 4AT completion, with assessments predominantly undertaken by medical staff despite the multidisciplinary nature of geriatric care. Aim: To improve multidisciplinary recognition, assessment and documentation of delirium by increasing staff knowledge, confidence and

Introduction An accurate Clinical Frailty Score (CFS) is a good predictor of surgical outcomes and should be documented correctly for all surgical patients. However, this is not always followed in practice. This project aims to identify discrepancies in CFS documentation between Emergency Department (ED) triage and the POPS (Perioperative care for Older People undergoing Surgery) team and explore adherence to POPS recommendations. Method This was conducted by the POPS team in a district general hospital in England. The CFS done preoperatively on vascular inpatients separately by ED triage

Improving insulin medicines reconciliation and glycaemic safety in frail hospitalised older adults: a quality improvement project Background Insulin is a high-risk medication, and prescribing errors are a recognised cause of inpatient harm. Accurate medicines reconciliation of pre-admission insulin regimens is essential for safe glycaemic management and continuity of care, particularly in frail older adults with multimorbidity, cognitive impairment and acute illness. This quality improvement project evaluated insulin medicines reconciliation and glycaemic safety practices on geriatric wards

Key words: acute frailty, triple assessment, comprehensive geriatric assessment, integrated discharge team (IDT) Introduction: The expansion of acute frailty services is essential to meet the needs of our ageing population. According to the UK Office for National Statistics 2021 census, over one-sixth of the population (18.6%, or 11.1 million people) were aged 65 and over, with this proportion expected to rise to 25% within the next 20 years. Acute Frailty Team (AFT) was introduced in Newcastle in December 2024, aiming to create a streamlined pathway to avoid unnecessary admission and

Introduction Frailty is a recognised clinical syndrome associated with increased vulnerability to adverse outcomes, including higher morbidity, prolonged hospital stays, and increased mortality. 1,2 Assessment of frailty, utilising Clinical Frailty Scale (CFS), rather than using chronological age and social history, supports individualised clinical decision-making by guiding treatment goals. 3,4 CFS provides a standardised, reproducible, and evidence-based measure of physiological reserve. 4 Despite its importance, frailty assessment is not consistently documented during hospital admissions

Patients with a hip fracture should start rehabilitation no later than the day after their operation (NICE Quality Statement). Only 69% of patients with a hip fracture were mobilised day one post operation in 2025 in North Tees Hospital putting it in the lowest performing quartile in the United Kingdom. Delayed mobilisation is shown to increase the risk of post-operative complications and increased lengths of hospital stay. The aim of this audit was to identify the percentage of patients mobilised day one and key barriers to mobilisation which could be addressed to reduce post operative

Cardiology in Older Persons: Identifying Opportunities to Prevent Deconditioning Through Early Multidisciplinary Rehabilitation Introduction: Older adults admitted under cardiology are at increased risk of frailty, functional decline and hospital-associated deconditioning. Acute illness, invasive procedures, complications and prolonged hospitalisation can further reduce mobility and independence. We undertook an audit of patients admitted under the Cardiology in Older Persons (COPs) pathway to identify opportunities for earlier rehabilitation and functional support. Method: A retrospective

Background: Patients with a learning disability (LD) are classified as vulnerable. This group of patients are reported to have a significantly younger median age of death (61 years), and receive poorer quality acute care. The Royal College of Physicians (RCP) acute care toolkit (2022) was developed to support doctors in prioritising specific aspects of care in hospital for these individuals. The national hip fracture database (NHFD) includes patients with a hip fracture over the age of 60 years old, meaning those with a LD who develop frailty younger are excluded. Our aim is to assess whether

Introduction Patients with advanced dementia admitted to surgical wards may experience pain that goes unrecognised due to communication barriers. The PAINAD (Pain Assessment in Advanced Dementia) tool, recommended for non-verbal pain assessment, was rarely or never used. This concern was identified through clinical observation and a retrospective review of surgical dementia patients. This audit sought to assess current use of PAINAD, evaluate adherence to local recommendations, and implement changes to improve pain assessment and outcomes. 2. Method A retrospective review was conducted using

Introduction: The expansion of acute frailty services is essential to meet the needs of our ageing population. According to the UK Office for National Statistics 2021 census, over one-sixth of the population (18.6%, or 11.1 million people) were aged 65 and over, with this proportion expected to rise to 25% within the next 20 years. Acute Frailty Team (AFT) was introduced in Newcastle in December 2024, aiming to create a streamlined pathway to avoid unnecessary admission and improving supportive discharges, the first frailty team in North-east England. The second audit cycle shows a decrease in

Introduction Delirium is a common and significant, but often underidentified cause of morbidity and mortality in older inpatients. Screening improves detection, management, patient outcomes, length of stay and readmission rates. NICE recommends the 4AT as the optimal screening tool for its accuracy, accessibility, and simplicity. The Trust’s protocol mandates 4AT assessment on clerking for all patients aged 65+. This project's primary aim was to audit 4AT screening on admission in the Geriatrics department. Secondary aims assessed documentation clarity: whether high 4AT scores (≥4) triggered

Introduction Prolonged bed rest in older hospitalised patients can contribute to deconditioning and loss of functional independence. Mealtimes provide a practical opportunity to encourage mobilisation. This quality improvement project assessed whether education and prompting could improve sitting out for lunch among older inpatients. Methods Ten inpatients aged ≥65 years on a rehabilitation/geriatric ward were observed over three consecutive days. Patients were assessed for their ability and clinical suitability to sit out for lunch. Where appropriate, patients who remained in bed were

Introduction: Developmental idiopathic scoliosis (DIS) is a lifelong musculoskeletal condition, despite decades of research, aetiology remains unconfirmed with theories that implicate genetic predisposition, asymmetric neuromuscular activity, biomechanical loading asymmetry, CNS maturational delay, and hormonal factors. Management is threshold-driven observation under 25 degrees, and from 25 to 40 degrees having brace wearing as optimal treatment, and beyond 40 degrees requiring surgery, leaving no active treatment tier between bracing and surgery. Methods: Clinical observations from a

Introduction: Urinary incontinence further exacerbated by prostate diseases are detrimental to quality of life and functional independence, Real-time Ultrasound (RTUS) provides an objective and non-invasive Pelvic Floor Muscle (PFM) retraining for continence management with older men. RTUS guided PFM rehabilitation in an older male patient with urinary incontinence secondary to prostatic enlargement provides baseline PFM function. Methods: Mandatory fluid fasting with only maximal 250 ml of H2O consumption to expand the bladder as required for transabdominal RTUS imaging. A male prostate

Introduction: Chronic heart failure (HF) is highly prevalent in older adults, in whom frailty is common and associated with poorer outcomes. Despite advances in guideline-directed medical therapy, concerns regarding tolerability and polypharmacy contribute to under-utilisation in frail patients. This study aimed to map existing evidence on how frailty is incorporated into HF interventional trials. Method: A scoping review was conducted of Medline, Ovid Embase, Cochrane CENTRAL, and ClinicalTrials.gov for HF interventional studies published up to August 2025 where frailty was assessed using a