Access-VIGIL (Access to Video Intervention In Geriatric cLinics) will look at whether living with frailty is a risk factor for not being unable to access a heath appointment by video. The study has been designed in collaboration with members of the Health Together Partnership. We will survey service users from hospital and community clinics across Bristol. We will ask people about their access, skills, and use of technology.  This information will help us to understand how best to deliver services to people living with frailty. It will also help to develop the VIGIL study.

 View a summary of the study here.

Project Details
Principal Investigator: Dr Philip Braude
Planned End Date: 01/07/2022
Local Ref: QI45607

VIGIL (Video Intervention In Geriatric cLinics) will look at comparing face-to-face against video appointments for delivering a geriatrician assessment before surgery. Many older people having an operation at North Bristol Trust are reviewed by a geriatrician (medical specialist in older people’s health). The review aims to improve health before surgery and support a person’s decision making by exploring the risks and benefits of surgery when taking into account their underlying health and values. Few other hospitals offer this service. Video clinics may allow better access to specialised services for people across the UK, while reducing travel with its environmental impact, as well as financial and physical burden on patients.

Patients will be invited to join the study if they are deciding on having an aortic artery aneurysm operation (enlargement of the main blood vessel in the body). The type of appointment, either face-to-face or by video, will be selected at random by a computer. This is a feasibility study to find out if a large study could work to compare the two types of appointment. This smaller study will not show which is better, but will help to sort out the complicated process of running a large trial in the future.

View a summary of the study here.

Project Details
Principal Investigator: Dr Philip Braude
Planned End Date: 01/06/2023
Local Ref: 5110

Funded by Bristol Health Research Charity and the British Geriatrics Society

FiTR 1 study will look at older adults admitted to hospital with serious injuries across all of England. We will look at how living with frailty affects a person’s recovery after a serious injury. Frailty is a measure of how vulnerable a person is to the effects of an illness or injury. The information used for this study is held by the national injury database run by the Trauma and Audit Research Network (TARN) and is managed by the University of Manchester. TARN collect information from all hospitals for people admitted with serious injuries.

View a summary of the study here.

Project Details
Principal Investigator: Dr Philip Braude
Planned End Date: 01/05/2022
Local Ref: 5036

FiTR 2 study will look at older adults admitted to hospital with serious injuries across all of England. We will look at how a geriatrician review (medical specialist in older people’s health) affects a person’s recovery after a serious injury. Geriatric assessment has been shown in single hospitals to cut the number of deaths up to a year after injury. The information used for this study is held by the national injury database run by the Trauma and Audit Research Network (TARN) and is managed by the University of Manchester. TARN collect information from all hospitals for people admitted with serious injuries.

View summary of study here.

Project Details
Principal Investigator: Dr Philip Braude
Planned End Date: 01/05/2022
Local Ref: 5036

DEFINE(surgery): Decisions Encompassing Frailty in Novel Environments will look at the abilities of surgeons to assess older people with complex heath needs. The study will ask healthcare professionals working in surgery to assess several made-up patient cases (case vignettes) using a frailty tool. They then will complete a questionnaire on how they feel they are able to recognise and manage older people living with frailty.

The information from this study will tell us how well healthcare professionals working in surgery are able to recognise frailty, and their experiences and confidence in doing this. We hope to improve education around frailty as well as make recommendations for hospital admission pathways.

Project Details
Principal Investigator: Dr Philip Braude
Planned End Date: 01/08/2022
Local Ref: 5146

Funded by the British Geriatric Society.

Philip Braude was appointed as a consultant geriatrician to North Bristol Trust in 2019. He setup the CLARITY group in 2021. He has been awarded a Bristol Research Charity Fellowship in 2021 to undertake the VIGIL (Video Intervention In Geriatric cLinic) study. He is undertaking a DPhil in frailty and trauma at the University of the West of England.

View Philip's published work here.

Ben Carter is a founding member of CLARITY and an honorary senior lecturer in medical statistics at North Bristol Trust and a substantive Reader at King’s College London. He has methodological interest in designing robust cohort, randomised controlled trials and systematic reviews.   His clinical interests include assessing the role of living with frailty and geriatric assessment.

View Ben's published work here.

Rob Grange is currently undertaking a fellowship in geriatric perioperative medicine at North Bristol Trust. During this time he has published abstracts on advance care planning and family communication, as well as co-authored a textbook chapter on the topic of perioperative medicine.

Sarah Ibitoye is an acute medicine and perioperative consultant appointed in 2022. She completed an MSc in Tropical and Infectious Disease with research methods in 2014. She is undertaking a perioperative medicine diploma at UCL. She has expertise in service development through research.

Andrea Joughin is a consultant geriatrician appointed to NBT in 2020. She completed a perioperative medicine fellowship at Guys and St Thomas in 2017. She has published works looking at national surveys of perioperative care and telemedicine for older people. She is a co-investigator on the VIGIL trial.

Emma Mitchell was appointed as a consultant geriatrician to North Bristol Trust in 2021. She has active interests in global ageing and health systems and been involved in Perioperative Medicine service development at NBT. She holds an Honorary Research Fellow post with the University of Bristol.

View Emma's published work here.

Dr Ed Richfield is a consultant in Elderly medicine with a sub-specialty of movement disorders, working at North Bristol NHS Trust. He completed his medical degree at the University of Liverpool, and post-graduate training in the Yorkshire deanery. His PhD, from Hull-York Medical School, is titled “Palliative care in Parkinson’s disease: developing a needs assessment tool”. 

He has been involved in the Neurology Academy as a delegate and faculty member since 2014 and sits on the British Geriatric Society (BGS) movement disorder special interest group committee. He is regional lead for the Parkinson’s Excellence network. He is a member of the International Movement disorders Society (MDS) working group exploring palliative care in Parkinson’s disease and currently chairs the clinical committee of the International Neuropalliative Care Society (INPCS).

Roxy is a Research Associate within the Institute of Psychiatry, Psychology, and Neuroscience at King’s College London. She has a PhD in psychology from the University of Southampton and has an interest in epidemiological research methods and statistics. Her research interests are varied, and include: developmental psychopathology, offending behaviour and mental health, military trauma, and frailty.

View Roxy's published work here.