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An old age problem

An old age problem
13 November 2013

Commissioning services for older people that integrate their often complex needs can be a challenge

Commissioning services for older people that integrate their often complex needs can be a challenge
Changes planned to local hospital services will ensure that local people get the best and safest care possible. A new older person’s assessment unit (OPAU) has opened on the Chase Farm Hospital site in Enfield, North London. This integrated healthcare system for older people is a new £3 million investment in services for older people at Chase Farm. The development is part of the implementation of the Barnet, Enfield and Haringey (BEH) Clinical Strategy, which was given the green light to make changes to services in November 2013 by local GPs and clinical commissioning groups (CCGs). Enfield CCG has continued to develop the specification so that it is an exciting keystone in the commissioning of integrated care for older people.
Older people with complex needs are those most likely to need help and are significant users of health and social care resources. For example, half of all the people who had a council-funded long-term care package were aged 75 or over in 2012/13, and the annual increase in the number of emergency hospital admissions of Enfield residents was predominantly driven by increases in admissions from the same age group. Older people with complex needs may benefit most from integrated care. 
People aged 60 or over will be treated in the older person’s assessment unit following a referral from their GP, community health carer or hospital clinician. Older patients have told us that they want more joined up health and social care, and to be helped to stay independent and in their own home for as long as possible. The main aim of the OPAU is therefore to ensure patients are treated closer to home and to avoid being admitted to hospital whenever possible unless that is the right place for them to be.
The OPAU will enable doctors and clinicians to identify patients quickly who may be at risk of becoming ill. They will work with other health professionals caring for older patients and will ensure that they can be assessed quickly and care packages put in place to help people to stay at home.
The unit has a multi-disciplinary team of health and social care professionals, headed by a consultant geriatrician. GPs will either be able to call the team for advice or, if an older patient becomes ill, book an urgent appointment. Patients will be able to access a range of diagnostic procedures on site including X-rays, blood tests and scans.
Wherever possible, a patient will be diagnosed and supported to return home with a care package. Most patients will not require an escalation of their care, but if a patient was in the OPAU and needed emergency care, they will be taken by ambulance to A&E and may be admitted to hospital. If a patient requires a rehabilitation bed, then the patient will be placed in the community until their condition has improved enough for them to return home. 

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