Prevalence of socioeconomic deprivation and risk factors in patients on the elective surgery waiting list in the North East and North Cumbria region of England: a cross-sectional study

\ua9 Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. OBJECTIVES: We examined the association of risk factors with socioeconomic deprivation in patients waiting for high volume low complexity (HVLC) surgical procedures in the North East and North Cumbria region. SETTINGS: We analysed data from the Rapid Actionable Insight Driving Reform database which links primary and secondary care elective waiting list data. PARTICIPANTS: Patients were included if they were waiting for HVLC surgery or an initial outpatient appointment for HVLC surgery. OUTCOMES: Smoking status, living with obesity, type 2 diabetes mellitus (T2DM), atrial fibrillation, chronic obstructive pulmonary disease (COPD), hypertension, serious mental illness or learning disability. Differences in outcomes by the England Index of Multiple Deprivation score quintiles were examined using ORs (95% CI). RESULTS: Of 78 571 patients, 30.6% were living in the most deprived quintile, 29.4% were living with obesity, 28.9% had hypertension and 13.5% were smokers. Though younger, 64.2% of patients in the most deprived quintile had at least one risk factor compared with 48% of patients in the least deprived quintile (OR 1.9 (95% CI 1.9, 2.0). The odds of being a smoker, living with obesity, T2DM, COPD and a serious mental illness or learning disability decreased as deprivation decreased in a dose-response relationship. CONCLUSIONS: People waiting for surgery from areas of greater deprivation are living with significantly more risk factors, and this may impact eligibility for surgery and surgical outcomes. Perioperative service provision must be delivered with deprivation in mind, otherwise health inequalities will be amplified

Measuring frailty in younger populations: a rapid review of evidence

Objectives Frailty is typically assessed in older populations. Identifying frailty in adults aged under 60 years may also have value, if it supports the delivery of timely care. We sought to identify how frailty is measured in younger populations, including evidence of the impact on patient outcomes and care.Design A rapid review of primary studies was conducted.Data sources Four databases, three sources of grey literature and reference lists of systematic reviews were searched in March 2020.Eligibility criteria Eligible studies measured frailty in populations aged under 60 years using experimental or observational designs, published after 2000 in English.Data extraction and synthesis Records were screened against review criteria. Study data were extracted with 20% of records checked for accuracy by a second researcher. Data were synthesised using a narrative approach.Results We identified 268 studies that measured frailty in samples that included people aged under 60 years. Of these, 85 studies reported evidence about measure validity. No measures were identified that were designed and validated to identify frailty exclusively in younger groups. However, in populations that included people aged over and under 60 years, cumulative deficit frailty indices, phenotype measures, the FRAIL Scale, the Liver Frailty Index and the Short Physical Performance Battery all demonstrated predictive validity for mortality and/or hospital admission. Evidence of criterion validity was rare. The extent to which measures possess validity across the younger adult age (18–59 years) spectrum was unclear. There was no evidence about the impact of measuring frailty in younger populations on patient outcomes and care.Conclusions Limited evidence suggests that frailty measures have predictive validity in younger populations. Further research is needed to clarify the validity of measures across the adult age spectrum, and explore the utility of measuring frailty in younger groups

New development: First steps towards an evaluation of the North East Transformation System

The North East Transformation System (NETS) is a programme that aims to engage the elements of NHS North East in a common vision, reshape the clinician/employer compact, and use Lean methodology to redesign work processes. After initial implementation in pathfinder sites, NETS is now to encompass other trusts in the region