Recent years have seen an increasing focus on reducing or avoiding admissions and delivering care at home and in community settings where possible. However, sometimes admission to hospital is essential and the drive to improve acute care for older people is a national priority. Healthcare Improvement Scotland has been leading a national programme of work with NHS board colleagues to improve older people’s acute care in NHSScotland since April 2012.

The programme has focused initially on two critical areas:

frailty – ensuring older people in hospital identified with frailty receive comprehensive geriatric assessment (CGA) within 24 hours of admission

delirium – increasing early identification and management of delirium.

The decision to focus on these particular areas of care was informed by a review of literature, themes emerging from the Healthcare Improvement Scotland inspection of older people’s acute hospitals reports, and an extensive period of consultation with stakeholders.