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Interface geriatrics

This presentation by Simon Conroy, Head of Service/Senior Lecturer in Geriatric Medicine at University Hospitals of Leicester, discusses the importance of evidence-based and educational solutions for frail older people. It highlights the need for integrated whole systems perspective and interdisciplinary team working. The presentation also covers the vertically integrated services for frail older people and the comprehensive geriatric assessment approach.

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Interface geriatrics

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  1. Interface geriatrics Simon Conroy Head of Service/Senior Lecturer, Geriatric Medicine University Hospitals of Leicester Speciality clinical director, Leicestershire Partnership NHS trust

  2. 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

  3. 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

  4. MDT Triage Trajectory Transfer Elderly frail unit (EFU)/Frail Older People’s Advice & Liaison Service (FOPAL) Specialist care Bed-based rehabilitation/ reablement In-patient CGA Intermediate care How we did it Frail older person in crisis SPA – clinical discussion Liaison

  5. Multi disciplinary team (MDT) Triage Trajectory Transfer Elderly frail unit (EFU)/Frail Older People’s Advice & Liaison Service (FOPAL) Specialist care Bed-based rehabilitation/ reablement In-patient Comprehensive Geriatric Assessment (CGA) Intermediate care Frail older person in crisis SPA – clinical discussion Liaison

  6. ED performance 2010-12: people 85+

  7. 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

  8. How we spread the message Dissemination Research • Evaluation of interface geriatrician role • Programme grant of emergency care of older people • Health service & delivery research (HSDR) grant on acute care of older people • External visits • Silver Book • ED curriculum • RCP acute care toolkit • BGS activity • Publications • Today! Research

  9. Summary • Urgent care = older people • Whole system solutions required • Vertically integrated • Holistic & interdisciplinary • Underpinned by robust communication and cooperation

  10. Contact details http://www2.le.ac.uk/departments/cardiovascular-sciences/people/conroy/the-silver-book/the-silver-book/ or spc3@le.ac.uk Thanks!

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