3152 Introducing an onco-geriatrics referral pathway for frail older adults living with cancer

Abstract Introduction The Royal College of Physicians (RCP) introduced guidance on implementing frailty assessment and management in oncology services in November 2023. Frailty-informed care has been demonstrated to improve outcomes. The RCP suggests that where the management of frailty is beyond the skillset of the oncology team, links should be built with local geriatric teams to ensure holistic care, responding to individual needs. Method We set up a referral pathway within an existing geriatric clinic at a district general hospital, facilitating referrals initially from oncology colleagues, then expanding to haematology. This was complemented by drop-in sessions and multi-disciplinary teaching sessions on frailty and comprehensive geriatric assessment. Results There were 23 referrals between January and November 2024. The median frailty score was 5. Cancer sites included rectal, urological, upper GI, lung and haematological malignancies. The majority of referrals were for polypharmacy (6), pre-treatment optimisation (6) and poor mobility (6). Other categories included falls and advance care planning. Patients waited between 2 and 21 days for an appointment. Outcomes for patients seen included rationalising medications (8); onward specialty team referral and investigations (7); multidisciplinary involvement (4) and advance care planning (2). Through our interventions, assessment of frailty score improved from 0 to 96% of patients in this sample. Conclusion and next steps We have demonstrated the feasibility of integrating an onco-geriatrics pathway into an existing geriatrics service and nurturing links between departments through regular teaching sessions. As well as improving access to services for older adults, this provides training opportunities to resident doctors. Patient survey data is currently being collected to look at the impact of this service on patient experience. Whilst outside the scope of the initial project, future work could look into whether the positive impact of this service translates into a reduction in re-admissions in this cohort of patients.