Policy and practice

Acute care for older people: local service developments of increasing impact, linked to a £2 million research grant (2009-2014) and publications in the British Medical Journal & Age Ageing, associated Royal College of Physicians’ toolkit and annual conferences since 2010. 

The service developments consisted of an iterative approach to delivering Comprehensive Geriatric Assessment to frail older people in urgent care, starting with ‘a ward within a ward’ (Acute Frailty Unit), then testing a liaison model (Frail Older People’s Advice & Liaison Service), maturing into a more robust, integrated ‘Emergency Frailty Unit’ combing the ward and liaison approach in the Emergency Department (ED). Eventually we established a larger ‘Acute Frailty Unit’ embedded within the medical admissions service in Leicester, as well as the ED service.

Our learning has influenced the wider NHS, e.g. site visits from more than 30 UK hospitals, international visits (New Zealand, Ireland, and Switzerland), visitors from the Royal College of Physicians’ Future Hospitals Commission and the Royal College of Nursing. Our work has been disseminated in a range of national websites, e.g. Future Hospital Commission and ‘Fab NHS stuff’, was shortlisted for the HSJ efficiency awards 2012, highly commended by NHS Innovations in 2012 and won the UHL ‘caring at its best’ award in 2013. Our work was cited by the Health Select Committee in 2013.

We have a wide range of collaborations and contacts with local, national and international leaders in the field.

• Simon Conroy and Jay Banerjee set up the joint EUSEM/EUGMS geriatric emergency medicine special interest group in 2014
• Simon Conroy and Jay Banerjee set up the joint GEM SiG involving the Royal College of Emergency Medicine, British Geriatrics Society and Society for Acute Medic in 2018
• Expert Advisory Group member, Canadian Institute for Health Information
• NHS Elect Advisory Board member, 2017+

Documents

• The Silver Book - guidelines for the emergency care of older people (>200,000 downloads, British Geriatrics Society)
• Acute care toolkit 3: Acute medical care for frail older people (Royal College of Physicians)

Esteem indicators

• Simon Conroy and Jay Banerjee work with the Acute Frailty Network which won the Royal College of Physicians’ Excellence in Patient Care Award 2018 for quality improvement
• Our work on acute care for frail older people was shortlisted for the University of Leicester Impact Awards, 2017
• Invited member, NCD Older People Geriatrician reference group, 2016
• We are focused on impact – making a difference: a 2016 survey of English hospital found that 56/98 (57%) respondents were aware of one or more Leicester urgent care initiatives, 44% specified Leicester schemes as influencing their service and 21% had implemented a Leicester initiative; the most widely accessed ‘Fab NHS stuff’ case study is from Leicester and our 2012 publication the Silver Book has been downloaded over 200,000 times.