Clinical Domains

Read separately, each is a specialty. Read together, they are one patient’s journey — and the patterns that hold across them are where this publication looks hardest.

1. D01 Acute Frailty Geriatric care from the start of an acute admission keeps more older people alive and at home; the NHS's clocks around it are consensus, and its measures count flow rather than outcomes Latest · 23 Oct · The electronic frailty index shows a graded association with mortality, but not that identifying frailty changes what happens next 46 signals 21 syntheses 17 patterns
2. D02 Clinical Psychology Closing the gap between psychological need and effective therapeutic contact — and treating the mind as part of physical-illness care, not an afterthought Latest · 9 Oct · Green health prescribing for older adults: many studies report benefit, few show significant effects, and certainty is low 25 signals 17 syntheses 9 patterns
3. D03 Palliative Care Earlier specialist palliative care improves quality of life and reduces aggressive hospital care at the end of life in cancer trials; whether it gets people to where they want to be is less well shown Latest · 16 Oct · Community palliative care benefit is attributed to five interacting mechanisms, not to the site of care 33 signals 21 syntheses 12 patterns
4. D04 Therapies and AHPs Functional independence gained per episode — rehabilitation matched to potential and delivered by coordinated teams, the one lever the trials clearly reward Latest · 23 Oct · Resistance exercise has the clearest pooled signal on frailty scores, but the range of true effects includes no benefit 30 signals 21 syntheses 13 patterns
5. D05 OPAT Equivalent clinical outcomes delivered out of hospital — and, increasingly, the recognition that the most value can come from not giving intravenous antibiotics at all Latest · 16 Oct · Seven outpatient parenteral antimicrobial therapy guidelines vary widely in methodological and reporting quality 19 signals 20 syntheses 10 patterns