Posters

Introduction The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) form supports advance care planning by documenting wishes for emergency treatment. This is particularly important for patients living with frailty who are susceptible to deterioration and loss of decision-making capacity. Documentation of ReSPECT status on admission is often missed. This project aimed to improve ReSPECT documentation during emergency general surgical clerking, and determine how often existing ReSPECT forms are going unnoticed. Additionally, documentation was analysed for patients with a

Introduction: Patients make different decisions when well informed, which is why shared decision making (SDM) should be at the forefront of healthcare 1 . Recently updated Academy of Medical Royal Colleges guidance for writing directly to patients ‘Please write to me’ 2 highlights the importance of SDM and giving the patient a written summary. In our Assessment and Rehabilitation Centre (ARC) at The Western General in Edinburgh, we wanted to evaluate how well we were incorporating SDM into our practice and learn from service users as to what they would like to see in a summary. Method: We used

Introduction Current NICE guidelines recommend urgent specialist assessment of patients with suspected transient ischaemic attack (TIA), to confirm or refute the diagnosis. However, in practice, many patients may have an alternative diagnosis. At Leeds Teaching Hospital NHS Trust (LTHT), patients with atypical features who are triaged as less likely to have a TIA may be referred to HOTTIA clinic. Understanding referral patterns and diagnostic outcomes may help identify patients better suited to alternative clinical pathways. Method A retrospective review conducted of patients in HOTTIA clinic

Introduction There is growing evidence that proactively intervening in frailty improves outcomes, though some have concerns about implications for GP workload. This project aimed to establish an integrated community neighbourhood health approach to proactively support adults living with frailty whilst minimising additional GP input. Methods General practice, Sussex Community Foundation Trust, Adult Social Care and VCSE organisations Age UK West Sussex, Brighton & Hove and Hangleton and Knoll Project worked together to deliver a modified-Comprehensive Geriatric Assessment to adults aged 65

Introduction Frailty Same Day Emergency Care (SDEC) is an increasingly utilised model supporting admission avoidance while providing an opportunity for multidisciplinary comprehensive geriatric assessment (CGA). One of they key aims of this is to shift focus from the acute hospital setting to the community and to support Neighbourhood Teams by communicating care needs through discharge summaries. Methods A quality improvement project was undertaken on an acute frailty unit (frailty SDEC). Baseline data were collected for 30 consecutive patients attending the unit over one month. Documentation

Introduction Strokes predominantly affect older adults, in whom atypical presentation, cognitive impairment and unwitnessed symptom onset may contribute to a delay in recognition. Timely access to neuroimaging is essential, as the benefit from thrombolysis is strongly time dependent. The National Stroke Service Model recommends neuroimaging within 20 minutes of hospital arrival. We aimed to improve the proportion of patients with suspected strokes meeting this standard at Sunderland Royal Hospital. Method We undertook a two-cycle quality improvement project. Our baseline measurement consisted

Introduction: Older people with multiple long-term conditions and polypharmacy are at increased risk of adverse health outcomes, including delirium. This study aimed to develop and validate prediction models for an individual’s risk of delirium within 1 and 5 years. Method: We conducted a retrospective observational cohort study using the Clinical Practice Research Datalink Aurum database. Participants were aged ≥65 years, prescribed at least one chronic medication, registered with a UK general practice between 1/10/2006 and 1/3/2023, and had at least 1 year of records. The primary outcome was

Background: Polypharmacy, often defined as the use of ≥5 medicines, is common in older people (OP). It increases the risk of inappropriate prescribing, which is associated with adverse health outcomes, including medication side-effects and hospitalisation. Medicines optimisation (MO) in OP is key to improving healthcare. This study aims to evaluate the knowledge and confidence of hospital pharmacists (including trainees) at MSEFT, in optimising medicines for OP. Method: A structured survey incorporating Likert-scale items was co-developed, to assess hospital pharmacists’ confidence, in

Introduction: Locally employed doctors (LEDs) frequently care for older people yet may lack structured education. National physician curricula identify core geriatric medicine capabilities including frailty, multimorbidity and end-of-life care. Our initial LED survey (n=22) revealed learning needs in managing acute deterioration (20/22), prioritisation (11/22), and appropriate escalation (10/22). We, as Clinical Teaching Fellows, therefore developed a simulation project to improve confidence in complex care of older people by integrating geriatric medicine core capabilities into acute

Introduction The Acute Frailty Service at Whittington Health NHS Trust provides Comprehensive Geriatric Assessment for frail patients attending the Emergency Department and acute wards during weekday working hours, focusing on same-day discharge. Patients who narrowly missed discharge were transferred to general medical teams, disrupting continuity of frailty care and potentially delaying discharge. In the absence of a dedicated frailty inpatient unit, a 24-hour Frailty Admission Pathway was introduced for patients expected to be discharged within 24-48 hours. We aimed to improve continuity of

Introduction Older people attending emergency departments (EDs) commonly present with frailty, multimorbidity and polypharmacy. Medicines optimisation is a key component of Comprehensive Geriatric Assessment and may improve patient outcomes, particularly in relation to falls prevention. Antrim Area Hospital ED has an established Early Intervention Team (EIT), but no dedicated pharmacist input. This service evaluation aimed to assess the impact of a Medicines Optimisation in Older People (MOOP) Independent Prescriber pharmacist providing medicines optimisation for older patients attending ED

Introduction: Antipsychotics in dementia are associated with higher risks of a wide range of serious health outcomes. Bradford is a national outlier in antipsychotic prescribing with 14.9% of dementia patients prescribed antipsychotics in March 2024 compared to 9% across England. Understanding and addressing the overuse of antipsychotics in BPSD is a priority for the Trust and the West Yorkshire Integrated Care Board (WYICB). Method: This 12-month quantitative service development project involved 78 care homes across Bradford District and Craven. Residents meeting deprescribing criteria were

Introduction: Understanding why Bradford is a national outlier in antipsychotic prescribing in dementia is a priority for the West Yorkshire Integrated Care Board (WYICB). Following a successful deprescribing project in 36 care homes in 2024/25—where 60% of antipsychotics were discontinued—it became evident that better understanding of care staff attitudes was needed. Engagement with deprescribing varied across care homes, and care staff attitudes appeared to influence deprescribing success. Method: A qualitative study was designed to explore care staff attitude and influence. Interviews were

Introduction: Many antipsychotics contribute to anticholinergic side effects, including confusion, cognitive decline, and increased dementia risk. Reducing antipsychotics in behavioural and psychological symptoms of dementia (BPSD) may lower these risks and is a priority in Bradford District and Craven. Method: Care home residents taking antipsychotics for BPSD were identified by a mental health nurse in conjunction with care home staff in a larger yearlong deprescribing project. Appropriate residents were enrolled into a deprescribing protocol. The deprescribing regime was communicated to

Key words: acute frailty, triple assessment, comprehensive geriatric assessment, integrated discharge team (IDT) Introduction: The expansion of acute frailty services is essential to meet the needs of our ageing population. According to the UK Office for National Statistics 2021 census, over one-sixth of the population (18.6%, or 11.1 million people) were aged 65 and over, with this proportion expected to rise to 25% within the next 20 years. Acute Frailty Team (AFT) was introduced in Newcastle in December 2024, aiming to create a streamlined pathway to avoid unnecessary admission and

Introduction Hospital admission can precipitate delirium and worsen outcomes for people living with dementia (PLwD), increasing length of stay (LoS), carer distress, and discharge to long‑term care. National Audit of Dementia data identified higher LoS and rates of discharge to 24‑hour care at SWFT compared with national averages. In response, a Dementia and Delirium Outreach Team (DDOT) was established in October 2024. This evaluation describes the development and early impact of this multidisciplinary intervention. Method DDOT comprises a Consultant Psychologist, Geriatricians, a Dementia

Introduction: A local audit of inpatient target oxygen saturation prescriptions identified multiple areas of inpatient care that were inconsistently addressed, prompting us to widen the scope of the audit. To provide a standardised approach to addressing these areas, we developed the ‘Harm-Free Care’ proforma (HFCP), which prompts healthcare professionals to review ten key areas of patient care on a weekly basis, including recent investigations, catheter care, bowel charts and nutrition. These are particularly important components of care in older patients, where regular reviews identify and

Introduction: Advance Care Planning (ACP) is a core component of high quality geriatric care, with the British Geriatrics Society (BGS) advocating a proactive, sensitive and patient centred approach, with recent guidance highlighting the importance of clear communication and documentation. Despite national guidance, ACP uptake and documentation at Doncaster Royal Infirmary remains variable and many patients do not die at their preferred place of death, despite the existence of a local ACP checklist. This quality improvement project aimed to improve clinician compliance and documentation with

Introduction Understanding the structure of higher specialty training is essential for future workforce planning in geriatric medicine. The British Geriatrics Society (BGS) Training Programme Director (TPD) survey provides a national overview of training patterns, workforce metrics and emerging challenges. This study reports findings from the 2025 survey and compares key trends with previous surveys. Methods UK geriatric medicine TPDs were invited to complete an electronic survey distributed by the BGS. The 2025 survey comprised 28 questions covering trainee numbers, recruitment, less than

Introduction Falls are the most common reason for attending the emergency department (ED) in adults ≥80 years. However, existing admission prediction decision support for this age group is lacking. This study aimed to develop an interpretable machine learning (ML) model and a bedside scoring system to predict hospital admission in this age group presenting with a fall to the ED. Methods A total of 7,464 retrospective attendances by 5,921 patients ≥80 years presenting with a fall to the ED were extracted from MIMIC-IV v3.1 and MIMIC-IV ED v2.2 (BIDMC, 2008-2019). A total of 110 predictors