UNLABELLED: The NHS 10-year plan aims to address health inequalities in service provision, provide appropriate mental health support to all ages, and upskill healthcare professionals working in mental health community services. This study involved three phases: Phase 1– a clinical audit, Phase 2– a survey exploring the perceptions of healthcare professionals in an Older Persons Specialist Service, and Phase 3– the implementation of the Plan-Do-Study-Act improvement strategy. Between 2015-2021, only 6% of older persons with experiences of hallucinations were referred to psychological services within a Community Mental Health Team (CMHT) Older Persons service, of whom only 1.3% received psychological interventions. When healthcare professionals’ opinions were surveyed within the CMHT, they felt a combined psychological and pharmaceutical approach would be most helpful for patients, however they felt less confident referring patients to psychological services and having those initial discussing with patients. Recommendations for services to aid professionals may include utilising assessment tools to assess and explore hallucinations in older persons, as well as NHS services collaborating with expert third sector organisations in order to access further training for healthcare professionals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-025-06831-7.