Geriatric medicine

Around 5-10% of people attending A&E departments are older and living with frailty, with more than 4,000 admissions daily for falls, minor infections, and adverse reactions to medications. Patients aged over 75 with frailty occupy about 20% of all bed days across England.

Demand for services is growing as people live longer. More than half of people aged 65 to 74 live with at least one long-term health condition, and the number of over-85s in England with dementia or other long-term health conditions is predicted to almost double from 233,000 in 2015 to 446,000 in 2035.

GIRFT’s national report for geriatric medicine recommends system-level working to offer more robust and accessible services for an ageing and frail population. This extends to offering more remote-care appointments, digitally-led services and improved data sharing among support services,

An integrated approach requires collaboration with place-based providers in primary and secondary care, community services, care homes, ambulatory, local authorities, and the voluntary sector to offer cohesive wrap-around care.

Geriatric medicine is part of GIRFT’s UEC portfolio >

Dr Adrian Hopper

Geriatric medicine clinical lead

Consultant Physician and Deputy Medical Director at Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London.

Dr Hopper is a physician with a special interest in geriatric medicine at GSTT. He is Deputy Medical Director for Patient Safety, and Clinical Director for Patient Safety at the Health Innovation Network in South London. He was also the Lead for the Medicine Clinical Academic Group for King’s Health Partners.

In 2009, Dr Hopper was awarded the NHS Leadership Award (Quality Champion), and in 2010 the BMJ Group Award for Clinical Leadership.

Dr Helen Skinner

Former geriatric medicine clinical advisor

Chief medical officer, stroke consultant and geriatrician at the University Hospitals of Morecambe Bay NHS Foundation Trust

Dr Skinner has been a consultant since 2006, initially working at North Tees and Hartlepool NHS Foundation Trust for 11 years leading the elderly care and stroke services before becoming the clinical director for out of hospital services.

Following a move to New Zealand she held leadership roles as a chief of service, general manager and chief medical officer for Canterbury District Health Board. Returning to the UK in 2022 she became the chief medical officer for Cornwall and the Isles of Scilly ICB before becoming the medical director for operational delivery at North Cumbria Integrated Care.

GIRFT report aims to bring together all sectors to collaborate on preventing frailty and avoiding hospital admissions

Getting It Right First Time’s (GIRFT) national report on geriatric medicine makes a series of recommendations to reinforce a system-wide collaborative approach to help prevent frailty and avoid the need for older people to be admitted to hospital where more effective care can be offered closer to home.

A population health management (PHM) approach to frailty is advocated in GIRFTs report to ensure regional partners provide joined-up care and alternatives to hospitalisation.

Avoiding hospital-acquired deconditioning (around a third of older people with frailty lose some of their ability to function during their stay) and improving delirium pathways (the confusion that commonly follows acute illness) are also considered key measures to support frailty patients.