Postcode lottery in healthcare? Findings from the Scottish National Comprehensive Geriatric Assessment in Secondary Care Audit 2019

Comprehensive Geriatric Assessment (CGA) is provided differently across Scotland. Scottish Care of Older People (SCoOP) CGA Audit was a national audit conducted in 2019 to assess this variation in acute hospitals. Two versions of audit questionnaires about provision of CGA were developed (one each for larger hospitals, and remote/rural areas) and piloted. The questionnaires were sent to representatives from all hospitals in Scotland using the REDCap (Research Electroinc Data Capture) system. The survey asked each service to provide information on CGA service de-livery at the ‘front door’. The questionnaire was open for completion between February and July 2019. Of the 28 Scottish Hospitals which receive acute admissions, we received information from 26 (92.9% response rate). Reporting sites included seven hospitals from remote and rural loca-tions in the Scottish Highlands and Islands. Significant variations were observed across par-ticipating sites for all key aspects studied: dedicated frailty units, routes of admission, staffing, liaison with other services and rehabilitation provision. 2019 SCoOP CGA audit highlights areas of CGA services which could be improved, and variation in specialist CGA service access, struc-ture and staffing at the front door across Scotland. Whether this variation has impact on out-come of older people requires further evaluation.