Nottingham University Hospitals NHS Trust (NUH) is one of England's largest acute teaching trusts. It was established on 1 April 2006 following the merger of Nottingham City Hospital and the Queen's Medical Centre NHS Trusts. They provide acute and specialist services to 2.5m people within Nottingham and surrounding communities at the Queen's Medical Centre (QMC) and the City Hospital campuses, as well as specialist services for a further 3-4m people from across the region.A merger with Sherwood Forest Hospitals NHS Foundation Trust was planned, and Peter Homa, Chief Executive of Nottingham at that time took the same role at Sherwood Forest, but refused to accept responsibility for the trust's £2.5bn private finance initiative contract. In 2016 Homa stepped down from the job at Sherwood Forest and in November 2016 it was announced that the merger would not proceed.
Background The assessment and management of impaired vision is included in falls prevention guidance. However, implementation is inconsistent. We conducted focus groups to explore the perspectives of Health Care Professionals (HCP) on vision screening in older adults attending acute hospitals following a fall. Methods A focus group study was undertaken with HCPs from a single-acute hospital trust. Semi-structured topic guides were informed by the Consolidated Framework for Implementation Research (CFIR). Transcripts were first inductively then deductively coded using CFIR constructs. Demographic data were collected and summarized. Results Five focus groups were conducted with 19 HCPs overall. Six interconnecting themes were identified, mapped to 14 CFIR constructs, relating to barriers and facilitators to vision screening. Barriers encompassed: lack of training, referral networks to manage impaired vision and prioritization of task-focused, rather than person-centered care, in the acute setting. Facilitators included: perceived mission alignment, adequate training, tools, guidance on roles, responsibilities and management pathways, integration of eye care professionals in multi-disciplinary falls care and time in job plans. Conclusions HCPs were motivated to vision screen and felt it aligned with person-centered falls care, however there were individual-, structural-, and organization-level barriers related to staff capability and opportunity to implement vision screening in the acute setting. Multi-component and multi-level interventions and implementation strategies are needed to integrate eye care professionals into the falls multi-disciplinary team, engage supportive leaders, develop an effective vision screening assessment, define roles, responsibilities, and management pathways, and organize individual training and time allocation for staff to perform screening.
To explore how non-geriatric specialists across UEMS bodies who care for older adults understand and approach frailty in order to guide future interspecialty educational initiatives. An online survey was conducted to capture their perspectives, practices and training needs regarding frailty. Non-geriatric specialists recognise the importance of frailty but report limited confidence and training, indicating a clear need for accessible and standardised education. Frailty in older adults is associated with increased vulnerability, poorer outcomes, and greater healthcare utilisation. To inform future inter-specialty educational initiatives, a survey across UEMS bodies was conducted. An online survey was disseminated between July and November 2025 via the UEMS Coordination team to all sections, divisions, multidisciplinary joint committees, and thematic federations. Eligible respondents were specialists not certified in Geriatric Medicine who provide care to older adults (≥ 65 years). Of 416 respondents, 283 were non-geriatric specialists caring for older people. They encompassed 40 specialties (40
Abstract Background Patient and Public Involvement and Engagement (PPIE) is increasingly recognised as essential to the relevance, feasibility, and impact of paediatric intensive/critical care research. However, reporting of PPIE processes and outcomes, particularly in child health studies, remains limited, often lacking detail on sustained involvement and its influence across the research lifecycle. Case study This case study presents the PPIE approach embedded within the OCEANIC Study, a multi-centre longitudinal mixed-methods investigation into the outcomes and support needs of children and families following paediatric intensive care unit (PICU) discharge. The study uniquely sustained engagement with a Children, Young People and Parent Advisory Group (CYPPAG) over eight years, aligning with the National Institute for Health and Care Research (NIHR) standards for public involvement. We detail the strategies used to foster inclusive, respectful, and impactful collaboration, including co-development of study materials, iterative feedback on recruitment and retention strategies, and involvement in qualitative data interpretation and dissemination. The advisory group’s contributions shaped study design, enhanced recruitment, and informed dissemination, including co-authorship and conference presentations. PPIE impact was explored qualitatively through CYPPAG feedback, tracking of study changes informed by the CYPPAG, and ongoing reflection within the research team. Conclusion The OCEANIC Study demonstrates the feasibility and value of longitudinal, embedded PPIE in paediatric critical care research. It offers a novel model for sustained advisory group involvement, evidencing how meaningful collaboration can improve research relevance, rigour, and reach. This case study provides actionable insights for researchers seeking to integrate PPIE across the research continuum and highlights the therapeutic and empowering impact of involvement for contributors.
Osteoporosis, a condition marked by increased fracture risk, remains under-diagnosed and under-treated worldwide, resulting in a substantial "treatment gap"-the difference between those eligible for osteoporosis treatment and those who actually receive it. While the concept of closing the treatment gap is commendable, and has galvanized clinical and policy efforts, this position statement argues that the prevailing narrative is in danger of becoming disease-focused and parentalistic, neglecting person-centered care. An international consensus group, including public contributors with lived experience were convened to define and characterize the "osteoporosis care gap" as a broader framework, encompassing deficits not only in pharmacological treatment but also in diagnosis, assessment, and multi-disciplinary management. The care gap is thus defined as "the discrepancy between the care provided to those at risk of osteoporotic fractures and best practice, person-centered care." Multi-level determinants of the care gap are identified including: societal-low public awareness underpinned by unhelpful stereotypes, and prevalent health inequalities; health policy-insufficient prioritization, diagnostic confusion, and lack of incentivization; healthcare service-fragmented care pathways with unclear roles and poor communication, inadequate follow-up, and insufficient support for shared decision making; and individual-unmet needs for care which is person-centered, participatory, understandable, equitable, holistic and multidisciplinary, and respects autonomy. The statement calls for a person-centered, equitable, and multidisciplinary approach to osteoporosis care, integrating the perspectives and needs of patients, families, and caregiver. Actions needed at societal and policy level are described, including increasing public awareness, increasing health policy prioritization, with clear professional leadership. The components of osteoporosis care are described in terms of case finding, assessment, treatment, and review. Addressing this, care gap requires coordinated efforts from policymakers, healthcare services, and professionals, with a renewed focus on equity and patient values and preferences.
To map and characterise major transnational initiatives in education and training in geriatrics, and to explore complementarities to support a more coherent and equitable global framework. Multiple transnational programmes operate across a wide spectrum of structures, educational approaches, and content, reflecting diverse regional priorities and stages of development. Coordinated collaboration amongst initiatives is essential to build global capacity, promote equity, and ensure sustainability in geriatrics education and workforce development. To map and characterise major transnational initiatives in geriatrics education and training, and explore complementarities as a basis for a more integrated and equitable global framework. A mapping exercise and expert consultation were undertaken by the European Geriatric Medicine Society (EuGMS) Special Interest Group on Education and Training between January and October 2025, including a meeting of international experts during the Twenty-First EuGMS Congress in Reykjavík. Eligible initiatives operated across national borders with an explicit mandate in education and training related to geriatrics and were not confined to a specific topic or subspecialty. Each initiative was profiled by scope, target audience, and contributions, and classified within a three-tier framework: (1) foundational capacity-building, (2) professional and interprofessional development, and (3) leadership and specialist advancement. Seventeen initiatives were identified. Tier 1 included the International Federation on Ageing (IFA), International Institute on Ageing, United Nations–Malta (INIA), PAHO’s ACAPEM (Basic), ASEAN’s Centre for Active Ageing and Innovation (ASEAN–ACAI), IAGG’s e-Training in Gerontology and Geriatrics (e-TRIGGER) programmes, WHO’s Integrated Care for Older People (WHO ICOPE approach), and AfriAGE. Tier 2 included the IAGG, EuGMS, EICA, PROGRAMMING CA2112, Victorian Geriatric Medicine Training Programme (VGMTP), and ACAPEM (Intermediate); and Tier 3 was represented by leadership academies (EAMA, ALMA, MEAMA/MENAAA, and AAMA), and UEMS–GMS. Collectively, these programmes form a considerably disjointed but potentially complementary global ecosystem for geriatrics education. Greater mutual awareness and alignment, anchored in equity and interprofessional inclusion, could enhance efficiency and sustainability in developing the global geriatrics workforce.
