Mapping the landscape of front door frailty in the United Kingdom: Lessons for further afield.

The ageing global population is posing a significant challenge to healthcare systems worldwide. Healthcare needs have become more complex and the demand for services is ever increasing. Identification of frailty at the front door of hospitals can prompt comprehensive geriatric assessment and streamline patients to the most suitable clinical area.

Nutritional Screening, Initial Management and Referral for Older People with Sarcopenia or Frailty - Results from a UK-Wide Survey.

Objectives: We surveyed healthcare staff working with older people to understand current practice in nutrition screening, initial management and referral for older people with sarcopenia and frailty.

Methods: We conducted a UK-wide web-based survey of staff working with older people in both hospital and community settings. Surveys were distributed through professional organisation e-mail lists and social media channels.

Frailty on the acute medical take.

Frailty is a prevalent condition in urgent care settings associated with an increased risk of adverse events. Frailty commonly presents on the acute medical take in the form of geriatric syndromes, which include falls, delirium and immobility. Comprehensive geriatric assessment is the evidence-based holistic approach to assessing and managing people with frailty.

Content of exercise programmes targeting older people with sarcopenia or frailty - findings from a UK survey.

Objectives: To establish whether existing exercise programmes offered to people with sarcopenia or frailty adhere to the current evidence base.

Methods: We conducted a national survey of practitioners delivering exercise programmes to older people with sarcopenia or frailty in the UK. The link to the online survey was distributed through email lists of professional societies, practice networks and social media.

Current practice in the diagnosis and management of sarcopenia and frailty - results from a UK-wide survey.

Objectives: Despite a rising clinical and research profile, there is limited information about how frailty and sarcopenia are diagnosed and managed in clinical practice. Our objective was to build a picture of current practice by conducting a survey of UK healthcare professionals.

Methods: We surveyed healthcare professionals in NHS organisations, using a series of four questionnaires.

Improving patient safety for older people in acute admissions: implementation of the Frailsafe checklist in 12 hospitals across the UK.

Background: checklists are increasingly proposed as a means to enhance safety and quality of care. However, their use has been met with variable levels of success. The Frailsafe project focused on introducing a checklist with the aim to increase completion of key clinical assessments and to facilitate communication for the care of older patients in acute admissions.

The emergence of sarcopenia as an important entity in older people.

Sarcopenia refers to the loss of muscle mass and strength seen with advancing age. The pathophysiology is multifactorial, with loss of muscle satellite cells, changes in hormonal systems, chronic inflammation, oxidative stress and anabolic resistance to protein utilisation all implicated. Older age, female sex and immobility are important risk factors.

Discharge to assess: transforming the discharge process of frail older patients.

The 2012 Royal College of Physicians report is clear that 'decisions about service redesign must be clinically led and clinicians must be prepared to challenge the way services - including their own service - are organised'. This paper describes a service redesign in which we have gained learning and experience in two areas. Firstly, a description of measured improvement by the innovation of redesigning the traditional hospital-based assessment of frail older patients' home support needs (assess to discharge) into their own home and meeting those needs in real time (discharge to assess).

Frailsafe: from conception to national breakthrough collaborative.

The number of people aged over 60 years worldwide is projected to rise from 605 million in 2000 to almost 2 billion by 2050, while those over 80 years will quadruple to 395 million. Two-thirds of UK acute hospital admissions are over 65, the highest consultation rate in general practice is in those aged 85-89 and the average age of elective surgical patients is increasing. Adjusting medical systems to meet the demographic imperative has been recognised by the World Health Organisation to be the next global healthcare priority and is a key feature of discussions on policy, health services structures, workforce reconfiguration and frontline care delivery.