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I’m A Medically Fit Patient...Get Me Out Of Here!

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E Godden1; R Cooper 1
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Introduction The GMC requires medical graduates to “recognise and show respect for the roles and expertise of other health and social care professionals”. Despite this, we identified a gap in final-year medical students’ understanding of the roles of multidisciplinary team (MDT) members in older patients’ discharge (OPD). Method As Clinical Fellows at Mid Yorkshire Teaching NHS Trust, we provide near-peer teaching for undergraduate medical students at the University of Leeds. We surveyed final-year medical students’ knowledge of MDT members’ roles in facilitating safe OPD, specifically
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Evaluating the Impact of a Pharmacist Independent Prescriber Service to the Older Person’s Acute Medical Unit

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Ruth Jones 1, Laura Rozier 1
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Introduction The pharmacist’s role has been shown to be beneficial in the care of older people, and literature advocates for their inclusion within multidisciplinary teams due to particular features of this patient group (including prevalence of polypharmacy, and changing pharmacokinetics and pharmacodynamics of ageing.) This work aims to evaluate the impact of a service change - namely the provision of a pharmacist independent prescriber (PIP) service (with a scope of practice and specialist interest in geriatrics), to the Older Person’s Acute Medical Unit (OPAMU). Method Data collection

Audit to Improve Discharge Summaries as per RCP Checklist

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M Bin Sabir; K Aziz; B Barrell; AJ Burgess.
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Introduction: A discharge summary is the primary and most important way of communication between primary and secondary care. Patients when discharged should have a good discharge summary as it works as handover between hospital doctors and the community medical services. The Royal College of Physicians (RCP) has a checklist for discharge summaries which shows the amount of information that should be added in the discharge summary. Method: 40 patient Data was collected retrospectively for patients who were discharged from Older Persons Assessment Unit (OPAU)- Morriston Hospital in August 2025

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Testing a novel Clinical Assessment Tool to identify Hospital-Acquired Deconditioning

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Elinor MacFarlane1; Siobhan Lewis2; Rachel Taylor3; Kathleen Withers1
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Introduction: Previous work identified eleven domains related to Hospital-Acquired Deconditioning (HAD), and a clinical assessment tool (CAT) was subsequently developed to measure changes in patient condition during a hospital stay. As the CAT aimed to identify and monitor HAD in hospital in-patients, testing was required to ensure the tool was appropriate for use. This project was funded by NHS Wales Six Goals Programme/Value Transformation and led by CEDAR. Methods: Two rounds of pilot testing were undertaken, involving staff members in two health boards. Iterative development continued
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Improving Medical Students' Confidence in Caring for Acutely Unwell and Dying Patients Using Simulation-Based Training

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Dr Tara Mathur, Dr Frances Mills-Baker
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Background and Aims The GMC specify foundation doctors must be competent assessing medical emergencies and making appropriate decisions during end-of-life care. However current literature identifies medical students’ confidence in palliative care skills, including communicating with dying patients and families is low, and many feel unprepared to attend emergencies. With an ageing population, and prevalence of frailty expected to rise significantly, competence in assessing acutely unwell older adults is essential for foundation doctors. This teaching programme aims to improve students’
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Age as a Poor Proxy for Frailty Complexity: A Comparative Analysis of 2023 and 2025 Frailty Census Data

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James Flynn 1; Talia Bartley 1; Roshni Sundar 1; Zena Marney 1
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Introduction Frailty represents a multidimensional vulnerability associated with adverse outcomes in hospital and community settings. Despite this complexity, chronological age is often used as a surrogate marker for frailty severity. This study evaluates whether age reliably reflects frailty complexity by analysing two frailty census datasets collected in 2023 and 2025. Method Two frailty data sets at PPH (June 2023 and December 2025) were examined. Key variables extracted included age and Clinical Frailty Score (CFS). Data were cleaned and converted to numeric formats. Only rows with valid

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“How Frail is our Hospital?”: A Comparative Analysis of Frailty Admissions in Prince Philip Hospital June 2023 and December 2025

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James Flynn 1; Talia Bartley 1; Roshni Sundar 1; Zena Marney 1
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Introduction Frail older adults account for a substantial proportion of unplanned hospital admissions. This study compares frailty-related admissions to Prince Philip Hospital (PPH) between June 2023 and December 2025 to evaluate changes in patient characteristics, prescribing burden, and admission pathways following standardisation of frailty data capture. Method A retrospective analysis was undertaken using standardised frailty datasets from June 2023 (n=77) and December 2025 (n=113). Variables included age, Clinical Frailty Score (CFS), polypharmacy prevalence, Anticholinergic Cognitive

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Improving recognition and management of acute delirium in older adults: A quality improvement project

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Sowmiya Gunabalasingam1, Ayida Khan1, Tun Moe1, Shumaila Manzoor1, Khalid Haque1
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Introduction Delirium in older adults is associated with increased morbidity, functional decline and mortality. NICE recommends the use of the 4AT within 24 hours of admission in adults aged ≥ 65 years. However, completion rates in clinical practice remain suboptimal. This quality improvement project aimed to improve recognition of acute delirium on a geriatric ward in Queen’s Hospital, by increasing the proportion of new ward admissions with a documented diagnosis of delirium and corresponding management plan by 20% through improved use of the 4AT. Methods Baseline data were collected over
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Comparison of polypharmacy and ACB in a cohort of older adults living with frailty at a DGH in Southwest Wales between 2023-2025

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Talia Bartley1, James Flynn2, Zena Marney3
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Introduction Polypharmacy is defined as use of 5+ medications. An anticholinergic burden score (ACB) 3+ increases risk of adverse outcomes in frail patients including falls, cognitive decline, and mortality. Optimising older adults’ medication regimen is a critical element of Comprehensive Geriatric Assessment (CGA). Method In December 2025 a frailty census was completed at Prince Philip Hospital (PPH). Criteria for inclusion were age ≥65 years. Data was collected for a range of metrics including Clinical Frailty Scale score (CFS), polypharmacy, anti-cholinergic burden, and whether admitted

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Evaluation of a Training Package for Clinical Frailty Scale Scoring in Urgent and Emergency Care.

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J Lai1; S Lewis2
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Objective: The Welsh Acute Frailty Service guidelines require Clinical Frailty Scale (CFS) completion within 60 minutes of arrival into urgent care outlining a clear need for staff to be confident using the CFS in these settings. This study evaluates use of a training package to educate healthcare staff on using the CFS in an acute setting. Method: Patient interviews were recorded in the emergency and acute medical units from which videos were created to explain how each patient’s CFS had been calculated. Patient stories and photographs were also used in an educational poster to support the
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Closing the Loop After Discharge: An IMT-Led Telephone Results Clinic in Geriatric Medicine

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Dr C Guy1, Dr D Paxton1
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Introduction Investigations requested as an inpatient were not reliably followed up in our hospital. Poor coordination of post-discharge follow-up can lead to delayed results review, threatening patient safety. This uncertainty contributes to increased length of stay, a risk factor for deconditioning and delirium. In older adults, results must be reviewed in the context of a Comprehensive Geriatric Assessment, allowing robust advanced care planning and ensuring onward investigations are tailored to the individual. We implemented a consultant-supervised, Internal Medicine Trainee (IMT)-led

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The Burden of Behavioural and Psychological Symptoms in Dementia (BPSD) in Post-Diagnostic Memory Services

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Abigail Campbell1, Lowri Elias1, Dr Cherry Shute2, Dr Biju Mohamed 2
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Introduction: BPSD significantly impact patient wellbeing and caregiver burden [1]. The Cardiff and Vale Memory Service provides integrated assessment, diagnosis and post-diagnostic care to around 5000 community-dwelling people with dementia (PwD) across South Wales. BPSD frequently prompt escalation to the multidisciplinary team (MDT). This project aimed to evaluate the burden of BPSD within the service. Method: Over 5 weeks, surveys were completed for patients discussed at the MDT with BPSD concerns. The survey captured number and type of BPSD features, demographics and routine clinical

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Delirium in Older Adults Admitted With Acute Stroke: Prevalence, Risk Factors, and In-Hospital Outcomes

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CMA Angulugaha Gamage 1; F H D Shehan Silva 2; Rajaratnam K 2.
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Introduction Delirium is a common, but frequently under-recognised complication in older adults admitted with acute stroke and is associated with adverse clinical outcomes. Data describing the prevalence, clinical profile, and impact of delirium in older adults with acute stroke in Sri Lanka are limited. Methods This descriptive cross-sectional study included 90 adults aged ≥60 years admitted with acute ischaemic stroke (including transient ischaemic attack) or haemorrhagic stroke to Professorial Medical Unit at Colombo South Teaching Hospital, Sri Lanka. Delirium was assessed using the

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Antihypertensive Prescribing in Older Adults: Are We Prescribing Correctly?

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Neelanjana Dutta1; Parul Singh1; Hafsa Promi1; Muhammad Azam2
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Introduction Hypertension is highly prevalent among older adults and is a major contributor to cardiovascular morbidity, mortality, and cognitive decline. While the HYVET trial demonstrated benefits of antihypertensive treatment in older populations, the SPRINT trial highlighted increased adverse events with intensive blood pressure control. This highlights the importance of ensuring antihypertensive prescribing in older people is appropriate and evidence-based, particularly in those presenting with falls. Method A retrospective observational review was conducted of 60 adults aged over 75

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Quality Improvement Project: Improving Multidisciplinary Meeting Documentation on Older Person Wards with an EPIC SmartPhrase

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Georgina Lindsay, Arianna Risoli, James Maguire
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Background A quality improvement project was undertaken on inpatient wards in the Ageing and Health department of Guy’s and St Thomas’ NHS Foundation Trust. The patient group comprised older adults predominantly living with frailty and multimorbidity. Care is delivered by a multidisciplinary team (MDT) including resident doctors, consultants, nurses, physiotherapists, occupational therapists, speech and language therapists (SALT), dieticians, and discharge coordinators. Introduction Reliable documentation of multidisciplinary meetings (MDMs) contributes to safe, coordinated and patient-centred
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Formation of a Frailty Assessment Unit - From Pilot to Reality

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E Mwendwa; A Falconer; H Morgan; B Adler; I Hynd; M Gallagher; E Burnett
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Background According to Healthcare Improvement Scotland, all hospitals should have an established frailty assessment area with access to a specialist frailty team within 4 hours of admission (or within 12 hours when out of hours). Timely CGA on admission is linked to improved patient outcomes. Last year at University Hospital Wishaw (UHW), a Rapid Access Frailty team (RAFT) with dedicated frailty beds was introduced over a 10-day period. They found an improvement with length of admission and discharge rates as well as positive feedback from staff. Following this pilot, a new Frailty Assessment

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Prediction of thirty day mortality using clinical risk scores in patients over sixty-five receiving systemic anticancer cancer therapy

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N Lander1, P Jenkins2
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Introduction: One third of cancers are diagnosed in patients over the age of 65 (1), given we have an ageing population this is going to increase. Tools have been developed to identify older patients at risk of increased morbidity when receiving SACT such as Geriatric 8 (G8) and Cancer and Ageing Research Group chemotherapy toxicity tool (CARG-TT). This project aimed to assess the ability of these and other frailty assessment tools to predict 30 day mortality amongst older oncology patients. Method: Morbidity and Mortality data from a regional oncology department was reviewed to identify

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Accuracy of doctors' decision of fast-track discharges: a prospective audit

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C Hayes1, R Shah1, A Summerbell1, M Tarek1, F Hendry2, A Abdelhafiz1
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Introduction: With an ageing population, more people are living with terminal illness, giving opportunities to identify those with predictable shortened life expectancy. The fast-track pathway was developed to speed up funding of care for people expected to die within 12 weeks. Our aim was to investigate the accuracy of doctors’ prediction of death for patients admitted to hospital and referred to the fast-track pathway. Methods: A prospective audit of hospitalised patients who were referred to the fast-track discharge pathway with an expected death within 12 weeks from the date of discharge

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CGA: Improving communication at discharge

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C Gribbon1; A Ucheoma2; K Maxwell2; E Nelson2; B McCann3
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Introduction: The most recent national frailty benchmarking audit showed that many discharge letters from our Frailty Ward did not document a clinical frailty score (CFS), advanced care planning (ACP) or functional status. This project aimed to improve documentation of the comprehensive geriatric assessment (CGA) for patients seen by the Frailty Intervention Team (FIT) in Craigavon Area Hospital. Methods A baseline audit of 20 discharge letters from the FIT team was performed, assessing whether core aspects of the CGA were documented. Aspects of the CGA included were: CFS, ACP, cognitive

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Are Older Adults with Chronic Kidney Disease Receiving the Correct Gabapentinoid Dose Based on Creatinine Clearance?

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Janaki Chaountharagnanan1,2; Rachael Fosuah1,2; Conor Symington1,2
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Introduction: Chronic Kidney Disease (CKD) affects around 10% of the Scottish population and is particularly prevalent among older adults. As renal function declines with age, drug clearance decreases, increasing the risk of systemic toxicity. Gabapentin and pregabalin, commonly used for neuropathic pain in older adults, are renally excreted and can accumulate, leading to sedation, confusion, and falls. Appropriate dose adjustment according to creatinine clearance (CrCl) is therefore essential. Despite national guidance from NICE, BNF, and SIGN, dosing errors in renal impairment remain a

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