Hospital-Wide Comprehensive Geriatric Assessment (HoW-CGA)

The Nuffield Trust, in collaboration with clinical investigators at the Universities of Leicester, Southampton and Newcastle, is part of a National Institute for Health Research (NIHR)-funded project to research acute hospital care for frail older people. The aim of the work is to inform NHS managers, clinicians, patients and the public about how best to organise hospital services for frail older people.

As part of this project, we have designed a tool for use by local providers (NHS acute trusts) and commissioners (local authorities) of care for older people (aged 75 years and older) in England as well as a series of practical guides on achieving hospital-wide comprehensive geriatric assessment.

Download a PDF containing all the content in this series.

HoW-CGA - Introduction to the service level toolkit

You are an anaesthetist, a surgeon, an oncology specialist, or other acute care physician. Team members’ training may not have focused on the needs of older people and may lack confidence and expertise in managing older people.

Clinical guidelines

HoW-CGA Chapter 1: Using data to identify problem and convince others about the solution

The first challenge on your improvement journey is to identify whether there are areas of the care you provide for frail older patients that could be improved, and then convincing others that the solution to the problem is the right one.

Clinical guidelines

How-CGA Chapter 2: Self-assessment

You may already have a good idea about the service outcomes you wish to improve. Evidence suggests that integrating assessment and management of frail older patients into your service is more effective than having a consultation geriatric service at arm’s length.

Clinical guidelines

HoW-CGA Chapter 3: Team approach to change

Designing solutions and delivering change is more effective when delivered by a core team of people who invest in engaging with a network of stakeholders. You may wish to start thinking about the advocates of improving care for frail older people in your service early.

Clinical guidelines

HoW-CGA Chapter 4: Barriers to implementation

The overarching message about successful improvement shows how social relationships in organisations are key for embedding the technical features of change. A lot of time and energy in leading organisational change will require you to uncover and mitigate barriers.

Clinical guidelines

HoW-CGA Chapter 5: Review, expansion and sustainability

Clinical guidelines

Hospital Wide Comprehensive Geriatric Assessment (HoW CGA) - History of the project

The aim of the Hospital Wide Comprehensive Geriatric Assessment (HoW CGA) project was to inform NHS managers, clinicians, patients and the public about how best to organise hospital services for frail older people.

Hospital Wide Comprehensive Geriatric Assessment (HoW-CGA): Overview

The aim of this project was to provide high quality evidence on delivering hospital-wide Comprehensive Geriatric Assessment (CGA). Comprehensive Geriatric Assessment (CGA) improves outcomes for frail older people, particularly on specialised wards.

The Hospital Wide Comprehensive Geriatric Assessment Study (HoW-CGA) - Public Information Leaflet

A public information publication on the benefits of a comprehensive geriatric assessment for an older person attending hospital.