Background As the prison population ages (Scottish Government. Scottish prison population statistics 2021–22.), it is important to understand and address the needs of people living with frailty in prison. A screening programme we introduced in our local prison found 10% of people aged 50 and over had moderate or severe frailty.

Aims To develop, introduce and evaluate a comprehensive assessment tool and Multi-Disciplinary Meeting (MDT) discussion process to identify and address unmet needs in people in prison living with moderate or severe frailty as identified on the Edmonton Frail Scale (EFS).

Methods Based on the Comprehensive Geriatric Assessment and the Health Improvement Scotland Falls and Frailty Tool we developed our own tool, the PRISON ABCD to holistically assess domains of need in people in prison with frailty. The tool looks at physical health, medications, environment, functioning, nutrition, sensory needs, mental health, cognition, mobility and future care planning. Any areas of challenge or unmet need are discussed at a monthly Frailty and Palliative Care MDT within the prison to identify solutions and further actions that are required.

Results The rehabilitation team complete the PRISON ABCD with those screened as moderately or severely frail on the EFS. This is then discussed at MDT which is attended by representatives from prison primary care, Scottish Prison Service, local hospice, chaplaincy, social carers, social work, mental health and rehab teams with an average attendance of 13. So far there have been 6 MDTs with 27 patient discussions taking place. Multiple areas of need have been identified across all domains of the PRISON ABCD tool with actions taken to address those needs.

Conclusion The PRISON ABCD tool can be used to holistically assess needs in people in prison living with frailty. Frailty MDTs allow discussion of unmet needs and identification of actions to improve care for people living with frailty in prison.