Posters

Deprivation of Liberties Safeguards (DoLS) are used across many areas of our hospital with 163 applications made within the past 10 months. When sampled the pre-intervention baseline compliance was 32.5.% for DoLS submissions with MCAs documented on electronic patient records (EPR). These gaps risk unlawful deprivation of liberty and compromised patient safety. This QIP primarily aims to improve legal compliance of DoLS to 70% within ten months. Initial intervention was the creation of awareness posters as well as a DoLS champion who delivered teaching sessions to F1s explaining how to

Introduction: Comprehensive Geriatric Assessment (CGA) is fundamental to the care of older adults but depends on accurate and consistent documentation. Our geriatric wards used a generic consultant ward round proforma that lacked prompts for key CGA domains, resulting in inconsistent documentation of frailty, cognition, functional status and advance care planning (ACP). This project aimed to improve the completeness and consistency of CGA documentation through a structured geriatric-specific consultant ward round proforma. Method: A Quality Improvement Project using the Plan–Do–Study–Act (PDSA

Background: As healthcare delivery increasingly shifts from Hospital-based to Community-based settings, it is essential that Geriatric Medicine training equips future Consultants with the skills required to deliver care closer to home. The 2025 BGS TPD report highlighted variation in training opportunities and experiences in Community Geriatrics across the UK. The BGS Healthcare in the Community Group (HCG) sought to explore Geriatric Medicine trainees’ experiences of training in Community Geriatrics subspecialty in more detail. Methods: Trainees were invited to complete a survey exploring

Introduction The proportion of older adults (≥65 years) admitted to the ICU is increasing in the UK. This population is particularly vulnerable because of frailty, polypharmacy and increased susceptibility to medication-related adverse effects, alongside the unique challenges of critical illness and complex post-operative recovery in the ICU. Many medications used peri-operatively and in the ICU have anticholinergic properties, increasing the risk of delirium, falls, urinary retention, prolonged ICU stay, and poorer clinical outcomes. We undertook a quality improvement project to increase

Social Dining at The Royal Free Hospital - Effects on Calorie Intake in Elderly Inpatients Introduction: Malnutrition and reduced oral intake are common among older inpatients and contribute to delayed healing, sarcopenia and prolonged hospital stay. Social dining has been shown to improve mealtime engagement and nutritional intake through factors including longer mealtimes, modelling of behaviour, social interaction and improved mood. Aim: To evaluate whether participation in a social dining (SD) lunch increases calorie intake compared with bedside lunch. Methods: Social dining sessions are

Recognising a gap in community Frailty provision in Ealing, the pilot was designed to test a consistent, scalable community frailty service model focused on proactive multi-agency support meeting local needs in line with the NHS 10-year plan. Key principles – data driven, proactive intervention and actions taken on by MDT members. Identify risk early – patients at greatest risk of escalation/admission using local dashboards and referrals by GP/MDT partners. Regular MDTs – partner representatives supporting virtual CGA. Co-ordinate care – dedicated care co-ordinator as a core MDT role. Enable

Introduction National guidance mandates delirium/cognitive screening for all older hospital patients (aged >65 years) with onward referral to memory services for suspected dementia. However, barriers between hospital and community services may impact this pathway. The Oxford University Hospitals physician/geriatrician-led memory clinic takes “internal” referrals directly from local secondary care services as well as from GPs. We determined the characteristics of this memory clinic population including referral route and degree of multimorbidity. Methods In a retrospective study of patients

Introduction Frailty affects around half of older adult inpatients and is associated with higher mortality. Newly qualified doctors are expected to recognise frailty and deliver end-of-life care (EOLC) but report low confidence due to limitations in undergraduate clinical exposure. We developed a simulation-based quality improvement project (QIP) to strengthen medical student confidence in recognising frailty and managing patients approaching the end of life. Method Using the Model for Improvement and three iterative Plan–Do–Study–Act (PDSA) cycles, we designed and refined simulations for

Introduction Signing off investigation results is essential to ensure timely and safe patient care. Missed results contribute to adverse patient outcomes and duplication of work. GGC Healthboard moved to electronic sign off of results in 2021; compliance has been poor. Project Aim: 80% of patients in the older patient's wards will have all results signed off within 48 hours of publication. Method Using PDSA methodology we tested several change ideas over 10 months: Creation of standard operating procedure with clear roles for residents and consultants. Shared via email, SharePoint and posters

Background: Frailty is associated with increased healthcare costs, accounting for over £5.8 billion annually in the UK (1). Frail adults experience higher rates of hospital admission, yet these patients often receive delayed assessment and specialist review. Comprehensive Geriatric Assessment (CGA) and early geriatric involvement have been shown to improve outcomes, including reduced length of stay (LOS) and readmission rates. In September 2025, a district general hospital serving over 250,000 residents, with an above-average population aged over 85 years (2), established its first dedicated

Introduction: Fragility fractures are common: 1 in 2 women and 1 in 5 men will sustain a fragility fracture in their lifetime. The majority occur in older adults age >65. They are costly for the patient and for the NHS - estimated £4.7 billion per year. Guidelines for primary prevention of fragility fractures recommend use of risk assessment tools like FRAX to direct need for pharmacological treatment, alongside optimisation of vitamin deficiencies and lifestyle factors. The aim of this project was to improve the proportion of patients presenting to the geriatric ward with a fall without an

Introduction Frailty FIRST is a community led project aimed at getting frail older adults back to their own homes with support and engaging community services to try and prevent further admissions. Last winter long ambulance waits and ED stays increased which has the biggest impact and harm on our frail older adults. Many of them could have been managed in the community and along with putting measures in place to try and reduce conveyances we used community in-reach into ED to get patients out on to Virtual Ward. This developed to include early discharge with consultant review and CGA at home

Title Implementing a Comprehensive Oncofrailty Service Across a Regional Cancer Centre: Early Outcomes from UHSussex Background The ageing population is driving a substantial increase in the number of older adults living with cancer. Frailty is associated with poorer treatment tolerance, increased healthcare utilisation and worse clinical outcomes. Comprehensive Geriatric Assessment (CGA) is recommended to support treatment decision-making and optimise outcomes for older people with cancer, yet access to dedicated oncofrailty services remains variable. In 2026, University Hospitals Sussex NHS

Introduction: Urinary catheterisation is a common intervention within the NHS. As with all medical interventions, there are associated risks, including infection, which may have a greater impact on older patients. Careful stewardship of catheter care is essential to prevent complications and maintain patient safety. However, there is a lack of clear national guidelines regarding catheterisation within the UK to support healthcare professionals. Aim: Improve documentation of urinary catheters and reduce the number of catheter-associated complications within two geriatric medicine wards of a

Introduction Hampshire and Isle of Wight Healthcare NHS Foundation Trust (HIOW) delivers a Hospital at Home (H@H) service providing acute care to patients with complex needs within the community. While physiological acuity is routinely assessed using tools such as NEWS2, these measures do not fully capture the objective complexity, dependency, and resource requirements of the H@H population. Robust assessment of acuity and complexity—and their translation into workforce planning—is essential to ensure safe, effective, and equitable care. This evaluation aimed to explore how acuity and

Introduction Intrinsic Capacity (IC), a concept proposed by the World Health Organisation (WHO), refers to the combination of an individual's physical and mental abilities. However, IC’s latent structure may vary across populations and measurement approaches, where frameworks derived elsewhere may not generalise well. Based on underlying domains of IC-related measures in an Asian older adult population, we developed an IC index, and evaluated its association with frailty. Methods A cross-sectional analysis was conducted using data from community screening events involving adults aged ≥50 years

Introduction Inpatient falls provide an opportunity to identify older people at increased risk of future fragility fractures and optimize bone health. Local practices suggested that fracture-risk assessment following inpatient falls was inconsistent. We audited compliance with NICE CG146 recommendations regarding fracture-risk assessment following inpatient falls and evaluated the impact of an educational intervention. Method Two data collection phases were conducted across five geriatric medicine wards. Patients sustaining an inpatient fall were identified through the DATIX incident reporting

Introduction Accurately identifying frailty at the front door is vital for guiding patient-centred care and Advanced Care Planning (ACP). Our quality improvement project set out to evaluate how effectively we assess frailty using the Clinical Frailty Scale (CFS) in patients over 65 admitted to Care of the Elderly (COTE) wards, looking specifically at completion rates, assessment timing, and ACP documentation. Method We first collected baseline data retrospectively for 35 frail patients admitted to COTE wards between December 2025 and February 2026, reviewing their records for CFS scores and

Introduction Delirium heavily impacts older adults undergoing emergency surgical admission, where perioperative stressors introduce a critical need for screening. The 4AT is a validated tool for rapid assessment. Whilst screening is robust in medical take, surgical compliance remains poor. This QIP aimed to improve 4AT compliance and reduce time to screening for older people aged ≥65 across the acute surgical take. Methods A baseline audit evaluated older individuals aged ≥65 admitted via the surgical take. Cycle 1 was run over 6 days, introducing computer bezel stickers in clerking areas and

Introduction National guidance recommends that resuscitation status is reviewed whenever a patient’s clinical circumstances change, including on readmission. At The Royal Free NHS Foundation Trust, if patients with previous Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions are re-admitted, they are considered to be “for resuscitation” thus they need to be reassessed on readmission. The Trust wished to encourage early review for people with previous DNACPR status, so as part of a re-design of the electronic process for DNACPR and treatment escalation plan (TEP), the Trust