Interface geriatrics mark II

Report
Interface geriatrics
Simon Conroy
Head of Service/Senior Lecturer, Geriatric
Medicine
University Hospitals of Leicester
Speciality clinical director,
Leicestershire Partnership NHS trust
Why this is important
• Evidence-based, educational solutions
– For frail older people
• Integrated whole systems perspective
– ‘Team without walls’
– Aligned to NHS priorities
• Holistic, generalist approach
– Interdisciplinary team working
What we did…
• Vertically integrated services for frail older
people
• Focussed comprehensive geriatric assessment,
including social care
– At and across the interfaces;
– Coordinated and communicated
• Horizontal integration (emergency department
(ED) and geriatrician (GER))
• Whole system, collaborative leadership
How we did it
Intermediate care
Frail older person
in crisis
SPA – clinical discussion
Bed-based rehabilitation/
reablement
MDT
Triage
Trajectory
Transfer
Liaison
Specialist care
Elderly
frail unit
(EFU)/Frail
Older
People’s
Advice &
Liaison
Service
(FOPAL)
In-patient
CGA
Intermediate care
Frail older person
in crisis
SPA – clinical discussion
Bed-based rehabilitation/
reablement
Multi disciplinary
team (MDT)
Triage
Trajectory
Transfer
Liaison
Specialist care
Elderly
frail unit
(EFU)/Frail
Older
People’s
Advice &
Liaison
Service
(FOPAL)
In-patient
Comprehensive
Geriatric
Assessment (CGA)
ED performance 2010-12: people 85+
How we kept it going
• Whole system focus on frail older people
– Clinical Commissioning Groups (CCGs),
psychiatry, social care
• Cost savings
– Acute - £0.5M
– Community - £0.75M
• Profile and capacity raising
– Fellowship in Emergency Geriatric medicine
– GP fellowship in Interface Geriatrics
– Emergency medicine curriculum changed
– IHI fellowship, Harvard
How we spread the message
Dissemination
• External visits
• Silver Book
• ED curriculum
• RCP acute care
toolkit
• BGS activity
• Publications
• Today!
Research
• Evaluation of
interface geriatrician
role
Research
•
Programme grant of
emergency care of
older people
• Health service &
delivery research
(HSDR) grant on
acute care of older
people
Summary
• Urgent care = older people
• Whole system solutions required
– Vertically integrated
– Holistic & interdisciplinary
– Underpinned by robust communication and
cooperation
Contact details
http://www2.le.ac.uk/departments/cardiovascularsciences/people/conroy/the-silver-book/the-silverbook/
or
[email protected]
Thanks!

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