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Background: This scoping survey is a preliminary part of the Scottish Care of Older People (SCoOP) audit programme, which aims to assess specialist service provision for older people with frailty in Scotland, and provide benchmarking data for improving services.\ud \ud Methods: The survey was distributed to nominated consultant geriatricians based in 12 of the 14 Scottish health boards who completed data to the ‘best of their knowledge’. Data collected were: consultant and specialty doctor level workforce; days of frailty unit operation; multidisciplinary team discussion frequency; and, physiotherapy and occupational therapy availability. Consultant cover was correlated with population data, and scores for service components used to derive separate acute and community service provision scores.\ud \ud Results: Consultant geriatrician availability varies widely across Scottish health boards with a median of 1.45 [range: 0.54–2.40; interquartile range (IQR): 0.71–2.28] full-time equivalent consultant geriatricians per 10,000 people ≥65 years. Variation was also present in the service provision scores [score range 0 (none) to 1.0 (very good)]: for acute services, the median national service provision score was 0.81 (range: 0.50–0.89; IQR: 0.75–0.85) and for community services 0.60 (range: 0.48–0.82; IQR: 0.52–0.65).\ud \ud Conclusions: This report clearly demonstrates mismatch between workforce and services in both acute and community settings in the context of the population size. Future surveys will build on this preliminary information to audit service provision for older people at an individual hospital level.

BackgroundThis scoping survey is a preliminary part of the Scottish Care of Older People (SCoOP) audit programme which aims to assess specialist service provision for older people with frailty in Scotland, and provide benchmarking data for improving.MethodsThe survey was distributed to nominated consultant geriatricians known to be based in 12 of the 14 Scottish health boards who completed data on the ‘best of their knowledge’. Data collected were: consultant and specialty doctor level workforce; days of frailty unit operation; MDT frequency; physiotherapy and occupational therapy availability. Consultant cover was correlated with population data, and scores for service components used to derive separate acute and community service provision scores.ResultsConsultant geriatrician availability varies widely across Scottish health boards with a median (range; interquartile range (IQR)) of 1.45 (0.54-2.40; IQR 0.71-2.28) FTE consultant geriatricians per 10,000 people ≥ 65 years. Variation was also present in the service provision scores (score range 0 (none) to 1.0 (very good)): for acute services, the median (range; IQR) national service provision score was 0.81 (0.50-0.89; 0.75-0.85) and for community services 0.60 (0.48-0.82; IQR 0.52-0.65).ConclusionsThis report clearly demonstrates mismatch between workforce, and services in both acute and community setting in the context of the population size. Future surveys will build on this preliminary information to audit service provision for older people at an individual hospital level.

With this project, we set out to investigate how trusting relationships develop in the workplace, and the consequences of losing trust. We began by exploring relevant literature and undertaking in-depth case studies, and in our original proposal we suggested experimenting with form and length of narrative material. It soon became clear that one page of text would be about the right amount to stimulate thinking among busy managers and OD/HR practitioners. So, following discussion with Roffey Park’s head of research, Dan Lucy, in June 2015, we agreed to produce a series of short readings that could act as ‘prompts’ for discussion and learning: (i) mini-stories about trust, drawn from our case studies, and (ii) short pieces reflecting on relevant literature, which originated as blog posts (see https://trustingrelationships.wordpress.com/) by either Rob or Alison.

CONTEXT: Care home residents are at risk of malnutrition through reduced overall food intake, ‘anabolic resistance’ in ageing muscle and high prevalence of medical morbidity and functional dependency. There has been limited consensus regarding effectiveness of a high protein diet on quality of life or clinical outcomes for care home residents.\ud \ud OBJECTIVE: To evaluate the effectiveness of non-meat, high protein supplementation on Health-Related Quality of Life (HRQOL) and relevant clinical and nutritional outcomes in older people in the care home setting. \ud \ud DATA SOURCES: We searched EMBASE, AMED, CINAHL, MEDLINE, and the Cochrane Registry of Clinical Trials, OpenGrey, clinicaltrials.gov, the WHO clinical trial registry and the ISRCTN and NIHR trial portfolio (to February 2018) for randomised controlled trials. \ud \ud DATA EXTRACTION: We extracted data from included trials if they assessed people aged 65 years and over living in care homes, who received a protein supplementation compared to not. \ud \ud DATA ANALYSIS: We assessed trial quality using Cochrane Risk of Bias tool and meta-analysis was undertaken when appropriate. \ud \ud RESULTS: 17 papers with 1,246 participants fulfilled the inclusion criteria. All studies were low or moderate quality. No evidence of improving HRQOL when the SF-36 was used (Standardised Mean Difference (SMD: -0.10; 95% CI: -0.51 to 0.31; p=0.62), although significant improvement was seen in the single trial using EQ-5D (SMD: 2.58; 95% CI: 2.05 to 3.10; p