Posters for 2025 Frailty and Urgent Care Meeting

Ensuring Consultant Geriatrician reviews for patients on the Older Persons Assessment Unit. Weston General Hospital (WGH) is working towards becoming a centre of excellence for frailty in keeping with its demographic. As part of this, there is a purpose-built Older Persons Assessment Unit (OPAU) compromising of 14 beds and Geriatric Emergency Medicine (GEM) unit compromising of 3 beds. Our OPAU medical team alongside the therapy team strive to ensure that each patient is reviewed by a Consultant Geriatrician during their admission, in addition to the routine medical and therapy teams to ensure

Introduction: Polypharmacy contributes to frailty, financially strains healthcare resources and causes unplanned hospital admissions. We audited how our Frailty Same Day Emergency Care (SDEC) addressed polypharmacy and the yearly financial impact of deprescribing on the NHS. Method: We analysed two months of patients seen and recorded medication changes in Excel. The BNF was used to provide the minimum NHS indicative price for a medication. Cost was calculated based on a year of prescribing for medications started, stopped or altered. For PRN medications, single pack usage was assumed. The

Introduction The development of specialist acute frailty services is well recognised as crucial to meet the needs of our ageing population and is recommended by the NHS England Long Term plan. At the same time, same day emergency care (SDEC) services are rapidly expanding as an alternative to ED However, to date there is a limited evidence base for specialist frailty SDEC units. Methods We ran a 6-week pilot of a 7-day specialist frailty SDEC open from 8am-6pm. The unit was staffed by consultant geriatricians, frailty ACPs, specialist nurses, junior doctors, a therapy team and resident

Introduction: Frailty scoring is important for the identification of frailty. Frailty assessment can aid clinicians in targeting comprehensive geriatric assessment to improve patient experience and outcomes. We explored the feasibility of self-assessment for frailty, comparing patient-reported scores with specialist clinician assessments, evaluating its potential as a tool for improving frailty identification and intervention. Methods: Between August 2024 and January 2025, a modified Rockwood frailty score with eight descriptive categories was issued to patients in the Older Person’s

Introduction: Urgent Community Response (UCR) teams need innovative solutions to deliver timely and effective care to frail older adults. This project explores the combined impact of remote assessment, continuous monitoring, and AI scribes to enhance UCR service delivery, aiming to improve patient care, staff efficiency, and resource utilisation. Methods: This service initiative integrates three key remote technological interventions within a UCR frailty service: Assessment: Digital examination devices (TytoCare) were used by Clinical Support Workers for remote clinician assessment. Data from

Introduction: Urgent Care Response (UCR) provides a rapid assessment, diagnostic and treatment service to prevent hospital admission. Occasionally, patients under the UCR team require acute hospital admission. Patients were experiencing long waits in the Emergency Department (ED), despite being referred directly from the UCR team due to the ED triage system. National Institute for Health and Care Excellence (NICE) recommends ensuring coordinated and patient-centred transfer of care from one healthcare team to another. We created an electronic alert icon to notify UCR referred patients to the

Frailty is prevalent within the local community of the hospital, with long waiting times in ED, the trust has established an FDF service, with a dedicated team based in ED to assess frailty patients, who would have been pended for admission, to ensure they are diverted to appropriate services and discharged to their normal place of residence, as per GRIFT, BGS guidelines and NHS England long term plan. Method Data was audited over a 7-month period, all patients who presented to the ED and pended for admission, who were aged over 65, with a Clinical frailty score over 4 Results The service has

Background Geriatric medicine in the Emergency Department (ED) represents an advancing field that integrates the principles of geriatric care into urgent care settings. Several studies have evaluated the impact of geriatrician consultations in ED’s on reducing hospital admissions, promoting safe discharges directly from the ED, and ensuring timely admissions to geriatric wards when necessary. However, to our knowledge, there have been no studies to assess the effectiveness of this intervention amongst those patients presenting after falls. Aim To evaluate the impact of geriatrician reviews in

Introduction Diabetes is a major health concern in the United Kingdom, contributing to both microvascular complications like nephropathy, etinopathy, and neuropathy, and macrovascular issues such as atherosclerosis, which can lead to stroke, myocardial infarction, and peripheral vascular disease. Older diabetic patients are particularly vulnerable due to frailty and multiple co-morbidities. Improved prescribing and monitoring could enhance care for this population. Methodology We conducted a review of older diabetic patients (>75 years) by examining their drug charts and treatment regimes

Background Delirium and acute functional decline are common in hospitalized older people (HOP), yet data remain scarce. A shortage of geriatricians and geriatric-trained doctors in our healthcare system contributes to poor clinical outcomes, including increased readmissions, morbidity, and mortality. This pilot study aims to assess the clinical burden of HOP—including rates of readmission, delirium, and acute functional decline—before implementing frailty care bundles in general medical wards. Methodology This prospective cross-sectional study recruited HOP (≥65 years) admitted to general

Introduction and Aims The Older People’s Same Day Emergency Care (OSDEC) unit at Portsmouth Hospitals University NHS Trust accepts admissions for older patients referred by South Central Ambulance Services (SCAS), aiming to deliver early patient reviews and reduce emergency department (ED) waits. Timely blood test results are critical for decision-making and early discharge. NHS England SDEC protocols recommend pathology access comparable to ED processes, though no national standards exist for pathology turnaround times. This quality improvement project aimed to implement targeted

Introduction Clinical simulation training is an effective active learning technique that is now incorporated into UK undergraduate and post graduate training. It is commonly used for advanced life support scenarios but to date its use in frailty education is limited. In view of the increasing numbers of people living with frailty, there is a need to develop frailty-specific education programmes that are inclusive for a range of multi-disciplinary team members. Methods A single day frailty simulation programme has been developed, using a mix of table top exercises and scenarios with actors and

Introduction: The Frailty Same Day Emergency Care (SDEC) unit at Fairfield General Hospital provides same day Comprehensive Geriatric Assessments (CGA). Bone health is an integral part of CGA, however recognition and management of osteoporosis is often not prioritised in acute hospital settings. We noticed that bone health was an area that was often overlooked within our CGAs. Our goal was to increase the number of bone health assessments performed and improve access to appropriate treatment for patients in the Frailty SDEC. The aim of this project was to increase the number of appropriately

Background: Laboratory-based frailty indices (FI-Lab) offer potential alternatives to manual assessment in emergency care settings, but how should we select features and time-frames to find the best balance between coverage and performance? We evaluated multiple FI-Lab configurations to determine the optimal configuration requirements for reliable automated frailty assessment. Methods: We analyzed 74,493 ED visits from 54,075 patients aged ≥70 years across two London hospitals (2017-2021), comparing five FI-Lab configurations and a drug-adjusted version against nurse-assessed Clinical Frailty

Background: Our recent research found significant visit-to-visit variability in nurse-assessed Clinical Frailty Scale (CFS) scores in Emergency Departments (ED), potentially limiting their reliability across patient encounters. This study investigated whether laboratory-based frailty indices could provide more stable assessments while maintaining clinical utility. Methods: We conducted a retrospective cohort study focusing on patients with multiple ED attendances between July 2017 and December 2021 across two London hospitals. From 23,956 patients with repeated visits (total visits = 60,381)

Introduction: It is important to identify delirium on admission as delirium increases patient mortality and also is linked to an increased length of hospital admission (1). Delirium is identified through a scoring system such as 4AT (2) and should be done on all patients over 65, with new confusion, or reduced mobility (3) as per NICE guidelines. The aim of the QIP is therefore to bring the department in line with NICE guidelines and increase the number of patients in the over 65 cohort having a cognitive assessment, and in particular looking at those with confusion and falls as these can be

Introduction The UCNH model is being implemented across Sussex to reduce ED pressures. Based at the Polegate Make Ready Centre, the UCNH launched in mid-November 2024 to provide alternative pathways for 999 callers. The UCNH operates as a multidisciplinary team of up to eight clinicians, including an Urgent Community Response Trainee Advanced Care Practitioner and a Consultant in Frailty, two Advanced Paramedic Practitioners, two Computer-Aided Dispatch drivers, and two remote consultation paramedics. Method The team triages calls, manages acute cases, and works collaboratively with ambulance

Introduction Malaysia is transitioning from an ageing to an aged nation. According to the Department of Statistics Malaysia (DOSM), 7.4% of Malaysia's population was aged 65 years or older in 2023, projected to exceed 15% by 2030. Frailty is increasingly prevalent, affecting 11% of adults aged 50–59 years and escalating to 51% among those aged 90 years or older, based on global data. A local pilot study in March 2024 in general medical wards highlighted common frailty-related issues, including deconditioning (36%), delirium (17%), and a 12-month readmission rate of 46%. Objectives To introduce

Introduction Early access to specialist care is recognised to be beneficial for older adults living with frailty. Decision-making around assessing function and mobility to facilitate safe discharge can be challenging for staff in an Emergency Department environment. This can result in patients being admitted to await specialist review. The aim of this test of change was to explore the role and contribution of a Specialist Frailty Allied Health Professional (AHP) within the ED and to evaluate the impact on the care of patients living with frailty. Methods For a 12-month period, the ED has had a

Neck of Femur Fractures (NOFF) - Educational QIP on Medication Management to Reduce Avoidable Hypotension and Acute Kidney Injury (AKI) Introduction Hip fractures prevalence increases with age. Patients aged ≥80 years have high morbidity and mortality risk following a hip fracture (hazard ratio for men [HR] 7.95, 95% CI 6.13-10.30 and HR women 5.75, 95% CI 4.94-6.67, respectively). Intraoperative hypotension is a risk factor for Acute Kidney Injury (AKI) after Neck of Femur Fracture (NOFF) surgery. The National NCEPOD AKI Report found a third of AKI is predictable and avoidable. Sodium-Glucose