Keeping the elderly out of hospital: a consultant comments

Published: 11th September 2015

When a patient is approaching the end of their life, the decisions GPs make have a disproportionately large impact. A decision to admit a patient to hospital may lead to them dying there, a decision not to admit may mean that they do not get the care they need. Having the confidence to make such judgment calls is a lot to ask.

This is one of the areas where Consultant Connect is making a difference. GPs in an area of Essex, when faced with a difficult decision to make regarding treatment of an elderly patient, can call Consultant Connect and, in under a minute, they can talk with a specialist Care of the Elderly consultant.

One of the Care of the Elderly specialists on the rota was kind enough to tell us a little about why consultants value the service: “GPs tend to concentrate on two main options when choosing to involve secondary care in the treatment of the elderly: admission to hospital and elective referrals. What is good about Consultant Connect is that, when I hear about a patient, I can also consider a same day domiciliary visit or recommending that the patient is brought to our assessment clinic.”

“Domiciliary visits used to be something we did more of. If there is a need, we can go and see a patient on the same day at their residence, which is often a nursing home. This is very important when making end of life care decisions – if a patient is taken to hospital, there is a risk that they will die in the hospital. A visit by a consultant to the patient’s home can give everyone the confidence that a care decision is the right one”.

On the Consultant Connect service itself, the consultant had this to say: “The convenience is amazing, it is surprising what you can achieve over the telephone. We’re getting to know GPs better, which is very useful, but the real achievements are in patient care. A couple of weeks ago I had a call from a GP who didn’t know whether to admit or refer a patient with a particular clinical condition. I advised an immediate change of medication and a blood test and that solved the problem. The patient avoided a trip to hospital and we saved ourselves an admission or referral. Amazing.”

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