Posters

Introduction Guideline-recommended medical therapy (GRMT) for heart failure with reduced ejection fraction (HFrEF) comprises four pillars, and their proactive implementation improves prognosis. The QUAD score promotes GRMT in HFrEF, but its applicability in older, frailer populations remains uncertain. Methods This retrospective observational study included patients ≥80 years with LVEF ≤40% who completed therapy titration between October 2023 – March 2025. Patients were identified from a Cardiology in Older People Service (COPS) and general cardiology clinics. Frailty markers (Clinical Frailty

Introduction Elective abdominal aortic aneurysm (AAA) repair is increasingly performed in older adults living with frailty and multimorbidity. Advancing technique, particularly endovascular aneurysm repair (EVAR) has widened access for those not previously considered for open surgery, with EVAR rising from 23% to 66% of repairs between 2022 and 2025, total volume nearly tripling within the South-East Wales Vascular Network (SEWVN). Despite national guidance and evidence supporting perioperative Comprehensive Geriatric Assessment (CGA) in Vascular Surgery, no structured referral pathway existed

Introduction Chest trauma carries significant morbidity, with up to 35% developing complications within 12–48 hours and mortality approaching 20% in frail, high-risk patients. Our hospital manages approximately 350 patients annually, cohorted on a dedicated ward. Initial care is under general surgical/perioperative teams before takeover of care (TOC) by respiratory if appropriate by current SOP. Baseline review demonstrated length of stay (LOS) was below the national average but patients transferred to respiratory experienced disproportionately longer LOS than those managed by perioperative

Introduction Gallstone related pathology accounts for a significant proportion of acute general surgery admissions. Attitudes and practices for surgical intervention in the cohort of older adults living with frailty, presenting acutely with gallstone related pathology, in particular CBD stones, varies across surgical units. We report outcomes from a single centre with established expertise and practice of single-stage cholecystectomy with bile duct exploration. Methods Retrospective cohort study of patients aged ≥80 undergoing emergency cholecystectomy at a busy DGH throughout 2025. Cases

Introduction PRIME (Perioperative Review Informing Management in Elective Surgery) is a specialist multidisciplinary pre-operative outpatient service. The clinic caters to patients aged over 65 with complex comorbidities through consultations with a geriatrician, anaesthetist, specialist physiotherapist and specialist occupational therapist. NICE guidelines suggest more emphasis needs to be placed on patient experiences of care(1). A survey of patient satisfaction of the PRIME service was completed to establish if any changes are required to improve patient experience. Method Design: Cross

Introduction: The Getting It Right First Time (GIRFT) Non-Ambulatory Fragility Fracture (NAFF) Pathway and British Orthopaedic Association Standards for Trauma (BOAST) recommend comprehensive orthogeriatric care for older adults with NAFFs. To address historical gaps in care, a dedicated NAFF service was established at the Royal Preston Hospital, aiming to provide comprehensive geriatric assessment within 72 hours of injury, including falls assessment, establishment of ceilings of care, and optimisation of bone health. Methods: A quality improvement audit was conducted over three cycles

Introduction: There are an increasing number of older adults undergoing elective surgery, with frailty being a stronger predictor of post-operative outcomes. The Pre-AMS frailty clinic was set up to evaluate frail patients undergoing elective surgery within the broader Preoperative Assessment Clinic (POAC) pathway. Through Comprehensive Geriatric Assessment (CGA), the Pre-AMS clinic evaluates frailty, multi-morbidity, cognition, poly-pharmacy, and functional status. This face to face, interactive joint assessment by anaesthetist and geriatricians with patients and families help early

Introduction: Diabetes and poor glycaemic control are major risk factors for peripheral arterial disease, lower limb ulceration and critical limb threatening ischaemia (CLTI).(1) Poor glycaemic control is linked with worse postoperative outcomes and increased mortality.(2) This two-cycle quality improvement project evaluated perioperative glycaemic management and escalation in vascular surgery inpatients. Aim: To assess compliance with trust guidelines for vascular surgery inpatient diabetes management and evaluate the impact of newly implemented guidelines and staff teaching on glycaemic

Introduction: Perioperative Medicine for Older People undergoing Surgery (POPS) provides preoperative Comprehensive Geriatric Assessment (CGA) and tailored optimisation to improve perioperative outcomes and inform shared decision making. With challenges of an ageing population, increasing service demand and fixed Consultant Geriatrician resource and physical capacity in the hospital setting, there is a need for innovation in service delivery. Building on established virtual Clinical Nurse Specialist (CNS) led telephone clinic follow-up within the POPS department, the POPS multidisciplinary

Background: UK guidance increasingly promotes disease-focused prevention strategies. The 2026 National Institute for Health and Care Excellence (NICE) guideline for type 2 diabetes mellitus (T2DM) advocates early initiation of metformin and sodium–glucose cotransporter-2 (SGLT2) inhibitors, while recent NICE cardiovascular prevention guidance supports intensive blood pressure and lipid lowering. In contrast, British Geriatrics Society (BGS) pragmatic prescribing guidance recommends individualised targets and treatment deintensification in people living with moderate-to-severe frailty. Whether

Introduction: The NHS routinely publishes data on hospitals’ 30-day readmissions. Readmission data is not yet collected by the National Hip Fracture Database (NHFD) or National Emergency Laparotomy Audit (NELA). We examined whether such data might provide a useful care quality indicator. Method: Retrospective review of 30-day readmissions after hip fracture or emergency laparotomy between January-March 2025 using local NHFD, NELA and electronic health records. We examined reasons for and impact of readmissions, whether any might have been avoided, and how. Results: The NHFD recorded 122

Introduction: Older adults undergoing emergency surgical admissions are at increased risk of delirium, adverse outcomes and hospital induced dependency. In our hospital, the Surgical Acute Frailty Team (SAFT) was established in March 2020 to provide early frailty identification, comprehensive geriatric assessment (CGA) and multidisciplinary intervention for older surgical patients based on the Centre for Perioperative Care Frailty Guidelines. Our aim was to establish the clinical activity of the service. Methods: A retrospective review of the clinical activity of SAFT from January 2021 to

Introduction ​Older adults undergoing emergency vascular surgery frequently exhibit frailty, delirium risk, and complex perioperative needs. We piloted a Perioperative care of Older People undergoing Surgery (POPS) service at the Somerset and North Devon Vascular Hub, adapting a general surgery POPS model for emergency vascular patients. ​ Methods ​Patients aged >65 were referred if meeting one criterion: Clinical Frailty Scale (CFS) ≥5, 4AT >4, or requiring complex decision-making support. Over three months, geriatric input included weekly ward rounds and Comprehensive Geriatric Assessments

Intro Older adults with reduced physiological reserve are more vulnerable to medication related adverse effects. Hypertensive management may contribute to Orthostatic Hypotension (OH), falls and functional decline. This clinical audit aimed to assess adherence to NICE guidance recommendation regarding Lying/Standing Blood Pressure (LSBP) measurement in adults with hypertension either aged ≥80 or with symptoms of OH and evaluate whether antihypertensive therapy was appropriately reviewed following recommendations of the British Geriatric Society Pragmatic Prescribing guidelines. Methods A two

Introduction Physical activity offers a variety of benefits to people with dementia, however, they may face a range of barriers to accessing physical activity opportunities. The Scottish Government have outlined a commitment to ensuring that people with dementia can receive non-pharmacological treatments, including physical activity programmes. This abstract summarises the preliminary findings from a scoping review regarding the availability and delivery characteristics of physical activity interventions for community-dwelling people with dementia in Scotland. Methods The Joanna Briggs

Background: St George’s hospital is the hub for the South West London vascular network admitting approximately 1400 elective patients yearly. A robust pre-operative assessment can identify areas requiring optimisation avoiding cancellation on the day of surgery which is costly to the hospital and patient. Introduction: Formerly, the pre-operative assessment involved three separate reviews by a clinical nurse specialist (CNS), physician associate (PA) and pharmacist. Patients reported poor satisfaction due to time spent and repetition. Anaesthetists reported inconsistent assessments and we

Introduction: Older adults living with frailty admitted to surgical wards have complex multidisciplinary needs and experience poorer outcomes than patients without frailty. Although well evidenced, access to comprehensive geriatric assessment (CGA) within our tertiary surgical centre is limited, with only 21% of inpatients with frailty receiving CGA. We evaluated the impact of introducing proactive CGA during a one-week quality improvement test of change. Methods: A proactive frailty service was implemented on general surgical wards at the Queen Elizabeth University Hospital, Glasgow

Introduction Clinically significant valve disease affects 11% of people in the UK aged 65 years and older1. Frailty predicts outcomes following aortic valve replacement (AVR)2, and its assessment prior to aortic valve intervention is recommended3. For patients who have already undergone AVR and are under surveillance in a valve clinic, national guidelines highlight the importance of assessing patients factors such as frailty to determine the appropriateness of ongoing follow-up4. We evaluated the frailty status of patients who had undergone AVR and were attending the Valve Clinic at Frimley

Introduction The National Emergency Laparotomy Audit (NELA) reports outcomes for patients who undergo surgery, but it also identifies a group of patients considered for laparotomy who did not proceed to theatre. This ‘NoLap’ cohort is often frail and at high predicted mortality risk yet receives far less scrutiny than the operative group. We audited these patients to assess how dying was recognised, how decisions were made, and what end-of-life care they received. Methods NoLap patients admitted to the Grange University Hospital in year 1 of the NELA were reviewed (n=18). Cases were assessed

Improving Heart Failure Management in Older People Introduction Heart failure is a major cause of hospital admission among older people and frequently co-exists with frailty, multimorbidity, cognitive impairment and polypharmacy. These factors increase the complexity of assessment, prescribing and discharge planning. A review of practice on geriatric medicine wards at Royal Preston Hospital identified variation in adherence to guideline-based heart failure management, particularly in documentation of heart failure phenotype, fluid status monitoring and medication optimisation. This project