Posters

Introduction Over 340 virtual hospital (VH) programs now operate across England, with a 60% increase between May 2022 and January 2023. Complex bone and joint infections (CBJIs) account for roughly 15% of Emergency Department caseload and disproportionately affect older adults, who face heightened risks from prolonged hospitalisation. Inpatient costs average £345/day. The Royal Berkshire Hospital established its Virtual Hospital in 2022 to provide outpatient monitoring and ambulatory treatment for CBJI patients. Given the paucity of data in this population, this study characterises

Background: Frailty, multimorbidity and polypharmacy are associated with poorer postoperative outcomes, increased complications and loss of functional independence. National guidance recommends early frailty identification and comprehensive geriatric assessment (CGA) within surgical pathways to facilitate optimisation and informed decision-making (1). A novel digital frailty self-screening pathway was introduced across elective surgical services within Swansea Bay University Health Board, enabling patients to identify potential frailty-related concerns and trigger referral to the existing

Influenza A Pneumonia Unmasking Platypnoea–Orthodeoxia Syndrome Secondary to Patent Foramen Ovale Background: Platypnoea–orthodeoxia syndrome (POS) is a rare condition characterised by dyspnoea and arterial desaturation in the upright position with improvement when supine. It results from right-to-left shunting and may arise from intracardiac causes, most commonly patent foramen ovale (PFO), or extracardiac mechanisms including pulmonary arteriovenous malformations, hepatopulmonary syndrome, parenchymal lung disease, and thoracic structural abnormalities. A precipitating factor is often

Introduction Delirium is common among older adults admitted to hospital and is associated with adverse outcomes. However, the magnitude of its association with in-hospital mortality and whether this differs between ward and intensive care unit (ICU) settings remain uncertain. This systematic review and meta-analysis evaluated the association between delirium present on admission and mortality. Methods Observational studies comparing outcomes in hospitalised older adults with and without delirium on admission were included. Meta-analysis was performed in R using the meta and metafor packages

Introduction A doctor's duty of care continues after a patient's death until the body leaves the hospital. Following a patient's death, doctors involved in their care receive reminder emails until a proposed Medical Certificate of Cause of Death (MCCD) is submitted. The case is then reviewed by a Medical Examiner (ME), who determines whether the cause of death is acceptable, requires amendment, or should be referred to the Coroner. Delays in completing this process can cause significant distress to bereaved families by delaying funeral arrangements and final rites. Method The Bereavement Team

Introduction: Frailty is increasingly encountered in clinical practice, yet undergraduate opportunities to develop confidence in managing older adults with frailty remain limited. We developed and evaluated a simulation-based teaching session aiming to enhance Swansea University medical students’ confidence in assessing and managing common frailty presentations. Methods: A frailty simulation teaching session was delivered to Year 3 Graduate Entry Medicine students during their frailty specialty attachment clinical placement. The sessions were delivered across two clinical sites, with each site

Introduction: The 2025 the Pembrokeshire inpatient census showed 75% of over 65-year-old inpatients have a Rockwood Clinical Frailty Score (RCF) ³>/=5, and 90% have one >/=4, highlighting a significant prevalence of frailty within this area. The Comprehensive Geriatric Assessment (GCA) is an evidence based aspiring practice for treating patients living with frailty. The Withybush Frailty Pathway model implements early identification of frailty, access to the MDT and continuity of consultant care retained throughout hospital stay. Methods: Patients presenting to Withybush Hospital with a RCF >/

Abstract Content : Introduction Falls in the elderly over the age of 65 are common, and the prevalence increases with age. Current NICE guidance on managing falls involving head injury in patients receiving anticoagulation can be challenging to interpret. Combined with increasing pressures on ambulance services and emergency departments (EDs), this prompted development of a collaborative admission avoidance pathway. Methods A joint head injury pathway was developed by the Royal Berkshire NHS Foundation Trust (acute hospital), Berkshire Healthcare NHS Foundation Trust (community physical and

ntroduction : Giant cell arteritis (GCA), also known as Horton’s disease - a large‑vessel vasculitis characterized by granulomatous inflammation of medium and large-sized arteries - is the most common primary systemic vasculitis in adults over the age of 50 [1]. It shows a strong predilection for women, particularly those of Northern European ancestry. The classical presentation includes new‑onset headache, scalp tenderness, jaw claudication and visual disturbance, though the clinical spectrum is heterogeneous and may overlap with other conditions common in older adults [2,3]. Delayed

Background 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 Frailty

Background The project was started as board round discussions were regularly taking over one hour, reducing the time available for ward work and causing team dissatisfaction. The team involved included the doctors on the ward, the senior nursing staff and members of the therapy teams. Methods In October 2025, a questionnaire was completed by team members asking how they felt board round could be improved. Improvements were then gradually implemented with verbal feedback throughout. Formal feedback was requested in January 2026, with a further round of interventions and feedback collected again

Introduction: People living with Parkinson's disease are frequently admitted to hospital, with many receiving care on frailty units. Timely medication administration for these patients is essential to reduce morbidity, mortality and length of stay. Current national evidence suggests that this is often not achieved. We therefore sought views from frailty unit staff to understand local barriers and develop a solution. A frequent theme was limited understanding of Parkinson's disease medications and the importance of timely administration. Based on these findings, we developed a 15-minute

Introduction:  Advance care plans (ACPs) powerful tools that outline an individual’s health preferences to aid healthcare professionals when considering treatment options for individuals who are at risk of losing capacity to make decisions. This quality improvement project was conducted to analyse the documentation of frailty, and advance care planning among patients discharged to a care facility from a geriatric ward; with one year follow up on patient outcomes. Method:  We conducted a retrospective study using discharge summaries, for patients discharged to a care facility from a geriatric

Introduction:  Advance Care planning and discussions around resuscitation are important, especially when resuscitation is deemed inappropriate. Dialysis patients have a higher number of co-morbidities and poorer physiological reserve than an average  patient. Therefore, it is important that advance care planning  and  resuscitation  status  is considered and documented appropriately  in these patients. Methods: Haemodialysis patients aged >65 years who regularly attend a dialysis unit in Morriston Hospital were included. Using Vital Data, Medical notes and Welsh Clinical Portal, their Charlson

Introduction Frailty is increasingly prevalent in ageing populations and contributes to rising age‑related conditions such as sarcopenia, which is linked to falls, functional decline and greater healthcare use. Early identification is recommended in EWGSOP2 (2019); SARC‑F offers simple screening, while handgrip strength (HGS) provides objective assessment but is harder to implement routinely. This observational study examined the feasibility of embedding Guideline‑aligned frailty and sarcopenia assessment across inpatient and outpatient services. Methods In March 2022, 70 older inpatients were

I recognised the need for improvement of the weekly MDT discussions on a care of the elderly ward. These meetings focused on ensuring each patient had a comprehensive geriatric assessment completed, and had input from a medical, nursing, physiotherapist(PT), occupational therapist(OT), social worker(SW) and pharmacist perspective. Measures for this project included ensuring a standardised proforma was used to document the MDT discussions. This included ensuring that staff present was recorded, clinical frailty score(CFS), functional status and escalation status for each patient was documented

Background: Neck of Femur fractures (NoFs) are associated with significant morbidity, mortality and prolonged hospital admission. These make up a significant portion of the Trauma and Orthopaedic admissions at Weston General Hospital. Optimal management requires multidisciplinary assessment and timely optimisation to meet the national targets for management of fractures. A review of the clerking proforma prior to this audit found variability in the documentation quality and completeness. Aim: To assess baseline documentation quality in NoF admissions and evaluate the impact of a redesigned

Introduction It is recognised that CPR should be based on an individual risk-benefit assessment, taking into account the likelihood of success, potential harms, and the patient’s wishes. RESPECT forms have been created to document personalised recommendations for emergency care based on discussions around a patient’s preferences, values, and wishes regarding future treatment and end-of-life care . This project aimed to assess and improve adherence to guidance from the Resuscitation Council UK regarding DNAR decision-making, patient + NOK discussions and documentation of these decisions with

Background Urinary tract infection (UTI) is frequently diagnosed in hospitalised older people, although non-specific presentations such as delirium, falls and confusion may occur without localising urinary symptoms. This can lead to unnecessary antibiotic exposure, delayed microbiological sampling and missed opportunities for antimicrobial de-escalation. Local problem An initial audit identified inconsistent assessment of urinary symptoms, delayed culture collection, variable adherence to local antimicrobial guidance and incomplete review of microbiology results. The aim was to improve

Introduction Falls are a leading cause of injury, hospital admission and loss of independence among older people. At the start of this project, NICE CG161 recommended comprehensive multifactorial falls assessment for older adults at risk of falls. During the second audit cycle, this guidance was superseded by NICE NG249 (2025). Review of the updated recommendations confirmed that the audit criteria and intervention still aligned with the current guideline. We evaluated documentation of multifactorial falls assessment and the impact of introducing a structured Outpatient Falls Risk Assessment