Supporting older people to stay safely at home through rapid specialist advice

Rapid Professional-to-Professional Advice via Consultant Connect has been available across NHS Greater Glasgow and Clyde since 2018, connecting clinicians with specialists for expert advice through secure telephone and photo messaging. More recently, in 2025, the Older Peoples Services (OPS), formerly known as Elderly Care, was refreshed to better reflect the pathway, creating a single point of access to specialist geriatric advice for clinicians caring for frail older adults in the community.

We spoke to Paul McLean, a Frailty Practitioner for a community rehabilitation team who regularly uses the service, and Dr Lesley Anderton, a Consultant Geriatrician at Queen Elizabeth University Hospital, who provides advice through the pathway, about the difference the service is making for clinicians and patients.

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Supporting timely clinical decision-making

Paul’s role focuses on supporting older adults to remain safe at home wherever possible, avoiding unnecessary hospital admissions whilst ensuring patients receive the right care at the right time. Working in an area with a high proportion of older residents means he is increasingly caring for patients with complex frailty, making rapid access to specialist advice invaluable.

‘Right away, you get a very obvious point of contact if you’re worried about a patient whose condition is deteriorating. One of our measures of success is trying to prevent patients from being admitted into hospital, so if I feel a patient is heading towards a hospital admission, the OPS line is extremely useful.

‘Having a conversation with a consultant means you can quickly put a recommended care plan in place that may help avoid admission altogether. If admission is unavoidable, you can get a head start on the investigations and planning needed to make the hospital stay as short as possible. It fills a lot of obvious gaps in communication that have been an issue before.’

‘Having the right conversation at the right time is incredibly valuable.’

Creating closer links between community and hospital teams

Alongside faster access to advice, Paul believes the service has helped strengthen relationships between community and hospital teams.

‘I very much feel that relationships have been established between the specialist and the caller. We’re all now on first-name terms, which is quite unusual. You don’t normally get that level of familiarity, particularly when you work in the community.’

A holistic view of complex patients

One patient in her 80s had experienced urinary tract infections and multiple courses of antibiotics over a year, but without a clear long-term management plan. Rather than focusing on another isolated episode of care, Paul used Consultant Connect to discuss the case with Dr Anderton, who reviewed the patient’s wider clinical history and recommended further investigations.

‘The patient wasn’t acutely unwell, but she was exactly the sort of patient who would benefit from my using Consultant Connect. Dr Anderton reviewed the case holistically and recommended additional blood tests and a bladder scan.

‘Having that consultant recommendation meant we could quickly arrange the investigation in the community. The bladder scan showed urinary retention, which led to a referral to urology. Instead of continuing to manage recurrent infections with individual courses of antibiotics, the patient now had a much more robust management plan.

‘Consultant Connect really helps with those chronic, complex cases where you need time to unpick a patient’s history and look at recurrent problems that don’t always have one clinician overseeing them. Having that dialogue is brilliant.’

Supporting shared decision-making across the system

For Dr Anderton, Consultant Connect has become an important way of strengthening links between hospital specialists and clinicians working in the community.

‘I’ve always loved Consultant Connect and have always tried to champion it within the department. The service reduces barriers as much as possible because once two clinicians speak, the patient’s pathway becomes easier to navigate.

‘Getting to know my colleagues in primary and community care and building those relationships is really valuable. Speaking directly, as close to being in person as possible, helps remove those barriers.’

‘Having another perspective before making a potentially difficult decision means that, most of the time, patients can stay home for longer.’

The conversations also create opportunities for shared learning between clinicians across different parts of the healthcare system.

‘There’s often an educational element as well. I learn what’s happening in the community and what colleagues can organise or prescribe, whilst I can share advice and practical information from the hospital perspective. It’s a really good way of supporting shared decision-making whilst learning from each other at the same time.’