The Government has made the care of vulnerable older people a central objective in improving and reforming health and social care services. Frail older people admitted for acute inpatient hospital care are at high risk of adverse events, have long stays, high readmission rates and high rates of long term care use. There is considerable evidence on how to assess and co-ordinate care for frail older patients with complex needs using Comprehensive Geriatric Assessment (CGA). However there is continued uncertainty about how to target suitable recipients in a hospital–wide manner and what is the most appropriate and cost-effective form of CGA for different settings.

This National Institute of Health Research (NIHR) funded project aims to inform NHS managers, clinicians, patients and the public about how best to organise services for frail older people in hospital. The Nuffield Trust is part of a large research consortium led by Newcastle University and includes researchers at University of Leicester, Southampton and Sheffield.

The objectives of this proposed integrated research programme are to systematically:

  • Define CGA, its processes, outcomes and costs from the existing evidence
  • Identify the processes, outcomes and costs of CGA in existing hospital settings in the UK
  • Identify the characteristics of the recipients and beneficiaries of CGA in existing hospital settings in the UK
  • Use this new knowledge to develop tools which will assist in the implementation of CGA on a hospital wide basis.

The Nuffield Trust will play a key role in using national, linked data sets to establish the potential population of frail older people who may benefit from CGA. In addition we will be performing an in-depth analysis of the connection between measures of frailty and the costs to the health and social care services by combining the national data with clinical data from specialised research databases. The results of this work will be published in peer review journals along with a broad dissemination agenda including blogs, conference proceedings and reports.

This project represents an opportunity to combine the very best of our research methodologies to address an important question in the care of frail older people and to impact the practice of care in the frontline delivery of health and social care services. It continues the portfolio of expertise the Nuffield Trust has established in this area.

This project was funded by the National Institute for Health Research Service Delivery and Organisation Programme (project number 12/5003/02).

The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HS&DR Programme, NIHR, NHS or the Department of Health.

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