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Our elderly medicine service provides a comprehensive range of specialist services recommended by the national service framework for older people, across all three of our hospitals.
A key element of this service includes acute care of older people, rehabilitation, acute stroke and orthogeriatrics, incorporating bone health and falls prevention.
We also have a broad range of specialist services for older people including specialist outpatients clinics, falls services, and community-based services.
Our TREAT (triage rapid elderly assessment team) service is a consultant-led multidisciplinary service to promote and facilitate safe discharge from the emergency department for complex and frail older patients.
Inpatient acute services are provided from dedicated wards at Barnet Hospital and at the Royal Free Hospital. Outpatient clinics are also held at both hospitals.
We have rehabilitation wards at Chase Farm Hospital and access to rehabilitation wards provided by other trusts at Edgware Community Hospital, Finchley Memorial Hospital, St Pancras Hospital, St Michael's Centre and Potters Bar Hospital.
We also work in close partnership with primary care and community teams to provide a specialist outreach service to older people in the community.
Frailty hub
We provide geriatrician expertise to community-based multidisciplinary teams which aim to maintain highly complex frail patients in their own homes and avoid unnecessary hospital admissions.
The Camden and Barnet community hubs review complex patients at risk of frequent admissions via weekly, community-based team meetings.
Day hospital
Edgware Community Hospital provides a specialist service for patients with Parkinson’s disease.
Care home outreach service (Camden)
This service aims to provide specialist input to support GPs, care homes and community teams to care for frail, complex older people in care homes in Camden.
Community hospital-based inpatient rehabilitation
Patients requiring rehabilitation are transferred to rehabilitation units at Chase Farm Hospital, Edgware Community Hospital, Finchley Memorial Hospital, Potters Bar Hospital or St Pancras Hospital.
All services delivered are based on the comprehensive geriatric assessment.
This is where the medical, psychological and functional capabilities of an older person are assessed in order to develop a coordinated plan for treatment and long-term follow-up.
We work closely with our nursing and therapy teams, as well as primary care and community teams, to deliver the best diagnosis, treatment and holistic care for older people.
Falls clinic
The falls clinic is a diagnostic service for people who experience an unexplained fall(s). There are links with community therapists and with other disciplines including audio-vestibular medicine, cardiology and neurology.
This service is provided at Barnet Hospital, Finchley Memorial Hospital and the Royal Free Hospital. We also provide monthly tilt table tests, where carotid sinus massage and prolonged head-up tilting can be performed.
Parkinson's clinic
We have consultants with expertise in the care of patients with Parkinson’s disease, providing services at Chase Farm Hospital, Edgware Community Hospital and the Royal Free Hospital.
Transient ischaemic attack (TIA) clinics
There is a daily consultant-led clinic service for patients who are suspected of having had a minor stroke. This service is run at Barnet Hospital and by the neurology service at the Royal Free Hospital, providing prompt access to assessments and investigations.
TREAT rapid access clinics
The TREAT team run daily clinics Monday to Friday, and offer older people the opportunity for a prompt, comprehensive clinical assessment to avoid unnecessary visits to the emergency department.
We provide a rapid diagnostics service as well as ensuring timely treatment, preventing further deterioration and the potential of unplanned hospitalisation.
Rapid access clinic
The rapid access clinic is a consultant-led clinic at Edgware Community Hospital, providing GPs with rapid access to a consultant opinion.
It facilitates referral of patients for diagnostics and on to appropriate support services.
Acute services
There are designated wards at Barnet Hospital (Juniper, Larch, Olive and Palm wards) and at the Royal Free Hospital (8 West and 10 North wards). These provide acute care for older people, each run by dedicated consultants with daily multidisciplinary rounds.
Stroke services
There are dedicated acute stroke units at Barnet Hospital and at the Royal Free Hospital, as well as rehabilitation beds at Chase Farm Hospital.
Our units provide care for stroke patients of all ages. Our local hyper-acute stroke unit is at University College Hospital.
Orthogeriatrics
The orthogeriatric service reviews all patients admitted with a fractured neck of femur (hip).
It aims to assess the patient pre-operatively and manage the patient post-operatively.
There is a built-in multi-disciplinary falls prevention weekly meeting as part of the service.
Other complex older emergency and elective orthopaedic patients are seen as required.
Triage rapid elderly assessment team (TREAT)
This is a consultant-led service, providing comprehensive geriatric assessment and management for older people accessing the emergency department at Barnet Hospital and at the Royal Free Hospital, with the aim of preventing avoidable admissions.
The service also runs a daily rapid access multidisciplinary clinic and a telephone advice hotline for GPs and community teams.
Older people’s assessment unit
Our older people's assessment unit at Chase Farm Hospital provides multidisciplinary assessments for patients referred from the community by their GPs, to ensure prompt treatment and prevent avoidable hospital admissions.
Referrals to our services can be made via a GP or a hospital doctor.
Electronic referrals from a GP may be made through the NHS e-Referral Service.
Access to our TREAT clinics are via our GP hotline telephone advice service (Monday to Friday, 9am to 5pm).
Outpatients
Referral to outpatients is via a GP, following standard referral routes.
TREAT — Royal Free Hospital
The clinic accepts referrals from GPs, the emergency department and community rapid response teams.
Referrals are via our switchboard — call 020 7794 0500 and ask for bleep 1026 (TREAT consultant or advance care practitioner).
The team can provide advice and signposting and also redirect patients to alternative clinics if a 'hot' clinic is not considered appropriate.
Listed below are websites you may find useful when looking for further information.
- Age UK
- Alzheimer’s Society
- NICE guidance for older people
- Parkinson’s UK
- Gold Standards Framework
- British Geriatrics Society
Please note, the Royal Free London is not responsible for the content of external sites.