Embedding National Benchmarking Within Integrated Intermediate Care Pathways: A Quality Improvement Protocol Using BEPOP to Enhance Exercise Provision for Frail Older Adults in the East of England

BackgroundFrailty and sarcopenia are leading contributors to disability and dependence in older adults. Despite robust evidence for resistance-based exercise interventions, clinical practice remains inconsistent, with wide variation in assessment, prescription, and follow-up. AimTo embed the national BEPOP (Benchmarking Exercise Programmes for Older People) framework within CPFTs Intermediate Care Service, integrating inpatient (Pathway 2) and community (Pathway 1) rehabilitation data to establish a baseline, implement targeted improvements, and evaluate outcomes post-intervention. MethodsA pre-post quality improvement design will involve participation in BEPOP benchmarking audit across two different waves as a structured framework. Data for 20 older adults ([≥]65 years) with frailty or sarcopenia will be audited and shared with the BEPOP team. Data across six stages--baseline, assessment, delivery, review, post-intervention, and follow-up-- will be collected via REDCap and benchmarked nationally by the BEPOP team. CPFT will evaluate local process fidelity, training impact, and documentation quality through a Plan- Do-Study-Act (PDSA) cycle spanning BEPOP Waves 3 and 4 (2025-2027). MeasuresPrimary: proportion of patients receiving objective strength assessment and follow-up reassessment. Secondary: exercise prescription fidelity, and clinician confidence. Anticipated ResultsImproved standardisation of assessment, enhanced cross-pathway collaboration, and strengthened integration of evidence-based exercise within routine frailty rehabilitation. ImpactThis initiative represents the first integration of BEPOP across both inpatient and community rehabilitation settings, offering a scalable model for embedding national benchmarking within local NHS services.