The vast majority of people in hospital are over the age of 65 and growing numbers of frail older people are admitted to hospital, often as an emergency. The number of emergency admissions to hospital among those aged 85 and over is rising and older people usually have longer stays in hospital, higher mortality, higher rates of re-admission and are more likely to be discharged to long-term care. Multiple morbidity and cognitive impairment increase with age and while age alone is not a predictor of frailty or delirium increasing age, long term conditions and acute illness all impact on the likelihood of an individual becoming frail or developing a delirium.

Service Description

This programme aims to improve care for older people in acute care. A major focus of the work to date has been on supporting teams across NHS Scotland to design, test and deliver outcomes in the two key areas of identification and management of frailty and delirium. A collaborative approach has underpinned the programme, with NHS boards sharing learning and opportunities with each other at national and regional events and seeking to identify opportunities for improvement through Older People Acute Hospital inspection processes.


From April 2017, the Older People in Acute Care programme joined with the SPSP Acute Adult programme to become the Acute Care Portfolio. ‘Frailty at the front door’ work now has its own separate page on the ibub website.



NHS Boards

Benefits of programme

This programme will continue to contribute to the growing awareness of key issues in older people’s care, specifically delirium and frailty, and has already influenced practice in this area. An impact report (PDF) of the work from April 2012 – March 2015 describes the approach taken, provides brief case studies and includes examples of progress (HIS, July 2015).

Related information

Find out more about available resources in the Delirium Toolkit