Posters

Introduction Malnutrition in older adults undergoing surgery is associated with increased adverse outcomes, hospitalisation and length of stay.  Preoperative nutrition risk screening is recommended for all patients undergoing intermediate or major surgery. In 2024, a Perioperative care of Older People undergoing Surgery (POPS) service was established in a tertiary centre to deliver comprehensive preoperative assessment and optimisation. In the absence of dietetic funding, a nutrition pathway was implemented to identify patients at risk of malnutrition using the Malnutrition Universal Screening

Background Emergency laparotomy (EmLap) is associated with high post-operative morbidity and mortality, especially in patients living with frailty. Patients who do survive can suffer a significant reduction in levels of independence and quality of life. Decision making and information exchange in this context is therefore critically important. Methods Semi structured interviews with patients and healthcare professionals were undertaken to identify factors recognised as important to the decision making process in the context of EmLap. Non-participatory ethnography at three different acute NHS

Background Emergency laparotomy (EL) is associated with significant patient morbidity and mortality, with potential subsequent reduction in post-operative quality of life and loss of independence. The decision to undergo an EL is therefore important. This project aimed to understand stakeholder perceptions of the decision making process in the context of EL. Methods Semi structured qualitative interviews were undertaken with relevant healthcare professionals, patients who had undergone an EL and family members involved in the decision making process prior to an EL. Interviews took place online

Introduction: We undertook a two-cycle quality improvement project in a district general hospital to improve completion rates for basic post-fall investigations in patients aged 65 years or older admitted to the General Surgery department for conservative management of head injuries or rib fractures sustained due to a fall. This is a vulnerable group of patients with extensive medical comorbidity and often a medical cause for their fall, yet their care takes place outside a geriatric service. Based on British Geriatrics Society and NICE guidance, we implemented pragmatic educational and

Introduction The management of silver trauma ( patients aged ≥ 65 with traumatic injuries or low-energy falls such as a fall from standing < 2 metres causing life- threatening injuries, resulting in ISS > 15) often suffers from delayed recognition, leading to poor pain control, prolonged lengths of stay and functional decline. This QIP aimed to align local emergency department practices with TARN and RCEM guidelines. Our targets were: Initial pain assessment within 15 minutes, Analgesia administration within 30 minutes, Pain reassessment at 30 minutes after analgesia, Silver trauma assessment

Introduction: Timely identification of frailty in the community is essential for implementation of support and strategies to slow progression of frailty, allowing older adults to live safer and more independent lives. Given the diverse MDT within primary, it is important that such members are equipped with the knowledge on how to recognise frailty, and what next steps should be taken to mitigate its course. Delayed recognition of frailty leads to a reduction in access to AHP support and poorer health outcomes. Our aim was to improve MDT-wide awareness and objective documentation of frailty in

Prevalence of Frailty in Heart Failure Patients in 1.1 million sized adult population of Mid & South Essex. Findings support recommending a “Frailty First” approach to managing Heart failure S Zaidi; R Thakkar Background: Heart failure (HF) and frailty have a bidirectional relationship. Although people with HF experience high rates of unplanned hospitalisation, most admissions in those with co-existing frailty are due to non-cardiac causes, including falls, acute kidney injury/electrolyte disturbance and bleeding events, rather than HF itself. These events are frequently related to adverse

Introduction: This quality improvement project aimed to improve falls prevention in elderly patients who presented to the A&E in Mid-Argyll Community Hospital and Integrated Care Centre — a rural hospital in Lochgilphead, Scotland. Falls affect around 30% of adults aged 65 and over and are a leading cause of injury in the elderly. Even patients classified as low risk have a 20–30% chance of a further fall within a year, and international guidelines recommend a proactive, multidisciplinary approach including physiotherapy and occupational therapy input to reduce this risk. A baseline audit of A

Abstract Nicotine has been investigated in prior studies for its analgesic effects and its impact on postoperative nausea and vomiting (PONV), yet results have been inconsistent. Objectives This systematic review and narrative synthesis evaluates the effects of perioperative nicotine administration on postoperative pain control and PONV in patients undergoing general anesthesia. Methods A systematic literature review was conducted, and findings were summarized narratively. Comprehensive searches were performed in PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google

Introduction Influenza infection poses a significant risk to patients with chronic heart failure (HF), mediating myocardial inflammation, haemodynamic instability, and acute decompensation. NICE guideline NG106 recommends annual influenza vaccination for all adults with HF. Despite this, vaccination uptake in this population remains inconsistently monitored at the primary care network level. This audit assessed compliance with this recommendation across the Watling Street Primary Care Network (PCN) in 2024. Method A retrospective audit of all patients with a coded diagnosis of chronic HF

Introduction Upon conducting a baseline audit assessing Colchester Hospital’s Care of the Elderly (COTE) wards’ adherence to NICE Quality Standard 63 — which states adults must have their diagnosis of delirium communicated to their GPs on discharge — it was found that compliance with this standard was suboptimal. This adversely impacts continuity of care. Data was collected across four COTE wards (Tiptree, D’Arcy, Birch and Peldon) for December 2023. Out of 80 patients, only 34 had their diagnosis communicated to GPs, meaning only 42.5% adherence to NICE guidance. This highlighted a clear gap

Introduction Frailty is a key predictor of adverse outcomes in hospitalised older adults. Assessing change in Clinical Frailty Score (CFS) from admission to discharge may reflect inpatient functional decline and quality of care. Method A retrospective audit of 40 medical inpatients was conducted at a district general hospital. Frailty was assessed using the Rockwood Clinical Frailty Scale at admission and discharge, with input from the multidisciplinary team including occupational therapists and nursing staff. Admission source (e.g., home, care home) and discharge destination (e.g., home

Background Older adults with frailty presenting with trauma or requiring emergency surgery represent a high-risk population with complex medical, cognitive and functional needs. While specialist older persons surgical services are increasingly established in tertiary centres, many district general hospitals (DGHs) lack dedicated frailty provision for emergency surgical patients. This variation affects patient outcomes, adherence to national standards and workforce sustainability, highlighting the need for pragmatic, deliverable models within existing DGH resources. Our aim was to develop and

Intro The geriatrics surgical liaison MDT aims to identify surgical patients with frailty who would benefit from comprehensive geriatric assessment (CGA). This involves taking referrals from both the surgical team and AHPs. There are weekly MDT meetings to identify rehab goals and any other relevant aspects of CGA assessment. Aim To determine the outcomes of the geriatrics surgical liaison MDT. Methods All patients who were discussed at the MDT meeting in a 14-week period from March to June 2026 were identified. A review of case notes was carried out to determine outcomes e.g. number of times

1.Introduction The Emergency Laparotomy and Laparoscopy Scottish Audit (ELLSA) commenced in 2019. This partly considers whether a geriatrician has reviewed patients undergoing emergency laparotomy aged over 65 with frailty or over 80. The ELLSA 2024 report showed the national average geriatrician review was 32.3% (target 75%). Glasgow Royal Infirmary had no dedicated laparotomy in-reach geriatrician process; therefore, we started developing a service. 2. Method Commencing January 2026, a spreadsheet of all patients over 75 for geriatrician review was made. Referral was placed by a dedicated

Introduction: Accurate discharge summaries are essential for ensuring continuity of care, particularly for frail orthopaedic patients. High-quality discharge communication has been associated with reduced post-discharge adverse events, medication errors, and hospital readmissions, while improving patient understanding of management plans. Following feedback from general practitioners regarding incomplete discharge summaries, we undertook this quality improvement project to evaluate the quality of orthopaedic discharge summaries and identify areas requiring improvement to support safe

Background: Individuals aged 60 years and above are undergoing surgical procedures, including resections for solid organ tumours. Surgery poses a significant physiological stress that disrupts normal homeostasis by affecting both the neuroendocrine and immune systems. When coupled with frailty, tumour-related metabolic demand and multiple co-morbidities, surgical stress predisposes older adults to poorer surgical outcomes, lower quality of life and institutionalisation. Prehabilitation aims to improve postoperative outcomes and enhance tolerance to surgical stress by optimising patients’

Introduction: Hip fractures are associated with significant mortality, prolonged hospital admission and loss of independence in older adults. Several risk assessment scores, including the Clinical Frailty Scale (CFS), American Society of Anaesthesiologists (ASA) grade, Nottingham Hip Fracture Score (NHFS) and RHMP30 score, are used to estimate patient risk. This study compared the association between these scoring systems and clinically relevant outcomes following hip fracture surgery to explore whether any score demonstrated a more consistent relationship with patient outcomes. Methods: A

Introduction The NHS is under unprecedented financial pressure, and emerging perioperative services for older people undergoing surgery are often difficult to fund, even where economic modelling suggests potential savings. After securing Royal Surrey Charity funding to join Cohort 4 of the NHS Elect POPS Improvement Collaborative, it became clear that funding for a new proactive POPS service would not be available. The team therefore explored what could be achieved within existing funded services for patients living with frailty who were referred for hip or knee arthroplasty. Method Quality

Introduction: Sigmoid volvulus (SV) is a common cause of large bowel obstruction in older adults, carrying high morbidity, mortality, and recurrence. Following a previous audit, a local SV management pathway based on international guidelines (Tian et al., 2023) was introduced in 2024 to standardise care. This re-audit evaluated pathway compliance and its clinical impact. Methods: Data was extracted retrospectively from electronic inpatient records for all patients admitted with SV between October 2024 and May 2026. Patient status at time of audit was also noted. Measures included demographics