Posters

Introduction Prolonged periods in the emergency department carry risk for people living with frailty. Early frailty assessment and multidisciplinary interventions can help support early discharge and avoid hospital admission. We have seen a 20% rise in ED attendances locally, for older people – Frailty ACPs can support redesigned emergency pathways through a single point of access and coordinate care from admission to discharge. Method Patients referred to the acute frailty service (≥75 years, CFS score ≥5 presenting with a frailty syndrome) were assessed by a Frailty ACP along with further

Title: A Systematic Review of Older LGBTQ+ Patients’ Experiences of Secondary Care Services Aim: This systematic review (SR) aims to synthesise the current evidence on the experiences of the older LGBTQ+ adult regarding secondary care, including acute care and outpatient services. Background: The Scottish Government (2023) states the over 65 population is now approx. 4% more than it was in 2011 at over one million people. As the general population of over 65’s grow, the older LGBTQ+ population will also grow. This is a diverse group of people with some differing healthcare needs, some of which

Introduction Nationally frailty take numbers are increasing leading to unacceptable ED trolley waits for frailty IP beds, increased corridor care and ambulance handover times. In Southmead the GP Frailty take especially has increased exponentially in the past 2 years, with referral numbers up by 50%. To address this problem the front door team are trialling an alternative way of working to improve efficiency. Method We had a frailty advanced practitioner tasked to be responsible for GP admissions to our acute frailty unit alongside a dedicated consultant geriatrician. They implemented a RAT

Introduction: Over 70,000 hip fractures are sustained annually in the UK (1), with the majority of these occurring in older adults. These patients are at high risk of delirium, with reported incidence between 14.4-29.3% (2,3). Perioperative delirium is associated with increased mortality, length of hospital stay and institutionalization. Delirium is more common in patients with pre-existing cognitive impairment. We aimed to estimate the magnitude of this association in a real-world setting to aid risk stratification and perioperative management. Methods: We performed a retrospective analysis

Background Frailty is highly prevalent amongst people living with kidney disease, and is set to increase as the population ages. In those aged over 80, or over 65 living with frailty, there is limited evidence of a survival benefit from renal replacement therapy (RRT) and clear evidence of poorer perceived quality of life. Despite this, shared decision making around alternatives to RRT is often not explored meaningfully. Methods Consultant geriatricians were embedded within the renal services of three London renal units. Referral criteria were patients within advanced kidney care clinics who

Introduction: Advance care planning (ACP) supports discussions about future care preferences but remains underutilised among older adults. Older adults hospitalised with fragility fractures represent a high-risk population with significant unmet ACP needs. Hospital admission may provide an opportunity to initiate ACP discussions. This review evaluated ACP interventions for older adults hospitalised with fragility fractures and described intervention characteristics. Methods: A systematic search of MEDLINE, Embase, CINAHL, PsycINFO, CENTRAL, Web of Science, and grey literature sources was

Introduction The Trust’s Advanced Kidney Care (AKC) outpatient clinics support people with stage 4 chronic kidney disease (CKD) and those on conservative kidney management. Best practice recommends early frailty identification and targeted intervention through integrated multidisciplinary care. Despite over 60% of AKC patients having a Clinical Frailty Scale (CFS) score ≥4, no structured frailty pathway existed, and occupational therapy (OT) and physiotherapy (PT) were absent from the service. This improvement project aimed to design, implement, and evaluate an integrated frailty pathway

Introduction Current treatment guidelines rarely specify when to stop medicines, contributing to potentially unnecessary or harmful medicines use. While deprescribing guidelines exist for some medicine classes, limited guidance is a major barrier to deprescribing. These new Australian clinical guidelines for deprescribing in older people address this gap by providing structured recommendations that complement more detailed drug-specific deprescribing guidance, disease-specific therapeutic guidelines and non-pharmacological management resources. Method The guideline development group of 72

Introduction Interstitial lung disease (ILD) is increasingly encountered in older adults, many of whom require prolonged or high-dose corticosteroids with additional immunosuppressive therapy. Although these treatments improve disease control, they increase the risk of Pneumocystis jirovecii pneumonia (PJP), an opportunistic infection associated with significant mortality. Current guidance recommends considering PJP prophylaxis in high-risk patients, yet uptake in routine practice remains inconsistent. We evaluated the characteristics and outcomes of PJP in older adults with ILD to identify

Introduction: As treatment for Human Immunodeficiency Virus (HIV) has developed, the proportion of older adults living with HIV has increased. These patients are susceptible to developing frailty, which is associated with functional impairment and prolonged hospitalisation. This project sought to evaluate the prevalence of frailty indicators and how often frailty and cognition were formally assessed among patients aged over 65 under the care of a tertiary HIV service. Methods: A retrospective service evaluation was conducted including 200 patients. Those who had died, or with incomplete or

Background Breast cancer is the most common cancer diagnosed among women in the UK. The incidence increases with age: older women with breast cancer represent a clinically complex population with more advanced disease. High rates of frailty, multimorbidity and underrepresentation in clinical trials contribute to variation in care. This service evaluation describes a novel joint geriatric oncology breast cancer clinic and reports its clinical activity, patient characteristics and outcomes over two sequential years. Method A two-year service evaluation was conducted at the Joint Geriatric

Introduction Delirium affects approximately 25% of patients following stroke and may prolong hospital admission, hinder rehabilitation progress and increase morbidity. To support early delirium recognition and optimise patient outcomes, the National Clinical Guideline for Stroke for the United Kingdom and Ireland (2023) recommends early and repeated cognitive screening using a validated tool, for example the 4AT. We audited compliance with 4AT delirium screening and repeat assessment for stroke inpatients at Northumbria Healthcare NHS Foundation Trust. Methods Patients discharged from two

Introduction Patients who are Medically Optimised for Discharge (MOFD) on Care of the Elderly (COTE) wards frequently receive unstructured review, falling into either cursory, poorly documented ward rounds or unnecessary over-medicalisation; both risk functional decline and prolonged admission. We aimed to improve the focus, efficiency and safety of inpatient care for MOFD patients across our COTE wards by implementing a structured MOFD checklist, targeting >90% compliance within six months. Method A quality improvement project used sequential Plan-Do-Study-Act (PDSA) cycles across four COTE

Introduction Inpatient falls are a common patient safety incident associated with increased morbidity, mortality and prolonged hospital stay.1 Head injuries account for a significant proportion of fall-related harm, making timely neurological observations essential for early detection of deterioration.2 A baseline audit identified poor compliance with trust inpatient falls guidance, particularly omission of neurological observations when clinically indicated. This quality improvement project aimed to increase the frequency of neurological observation monitoring following inpatient falls on an

Introduction Frailty is associated with functional decline, multimorbidity and increased emergency healthcare use. Comprehensive Geriatric Assessment (CGA) is the gold standard for frailty management but remains difficult to access for many housebound older adults. Proactive Ageing Well Service (PAWS) are being established across Southeast London (SEL). This service evaluation reports the population assessed, interventions delivered and healthcare utilisation of those receiving specialist multidisciplinary CGA at home through an integrated neighbourhood model in 2 of the SEL boroughs, Lambeth

Anticholinergic medications are associated with increased risk of falls and cognitive impairment in older adults, yet anticholinergic burden is not routinely considered during medication review. Through a two-cycle quality improvement project, we aimed to improve recognition of anticholinergic burden among patients aged ≥65 years admitted with falls and/or confusion and evaluate whether a simple educational intervention could reduce the proportion of these at-risk patients with anticholinergic burden. This quality improvement project was undertaken across a total of seven Care of the Elderly

Introduction Care home residents with advanced frailty often experience repeated acute transfers near the limits of clinical benefit, yet anticipatory planning may be absent until crisis admission. This audit assessed availability of comprehensive Advance Care Plans (ACPs) before transfer and whether acute admission was associated with reactive resuscitation-focused documentation. Methods A retrospective review was undertaken of 146 acute medical admissions from care homes to Prince Philip Hospital between 1 September 2024 and 30 April 2025. Electronic records were analysed for Clinical

Introduction Some age-related language used by healthcare professionals can be perceived negatively by older people and can harm patient-professional relationships. The British Geriatrics Society (BGS) has published guidance promoting respectful, person-centred language. This two-cycle quality improvement project aimed to evaluate and improve age-related language used within Newcastle University's MBBS programme. Methods Cycle 1 reviewed written materials within the Year 2 curriculum that had particular emphasis on older people's medicine. Ethical approval was therefore not required. We

Background and aim Unnecessary blood testing increases patient discomfort, workload and costs. We aimed to reduce unnecessary blood tests by standardising decisions about testing frequency and increasing senior clinical oversight. Methods and interventions Monthly blood-test activity was collected from September 2024 - June 2025. In July 2025 we used a Plan–Do–Study–Act approach. Cycle 1 involved local education, discussion at safety huddles and consultants setting expectations for frequency of blood tests during ward rounds. Business managers supported with messaging and data collection. The

Background: Frailty is strongly associated with delayed emergency assessment, prolonged hospital admission, functional decline and in-hospital mortality. The importance of the integration of fSDECs into acute medical care is highlighted by the NHS FRAIL strategy and the RCP[1]. Musgrove Park Hospital is a rural DGH serving a significantly higher percentage of older adults than the national average (>25% vs 18.5%)[2]. We have introduced a fSDEC pilot that aims to facilitate early comprehensive geriatric assessments (CGA) and avoid unnecessary admissions. We plan to identify barriers in this