A keynote speaker at our Innovations in the delivery of care for older people event, Professor John Young, National Clinical Director for the Frail Elderly and Integration, NHS England, explores the challenges frailty presents for health and care – it is not a disease and affects the whole body and each person differently.
In his talk, John introduces a new cost-effective coding system, currently under trial in primary care, which focuses on the earlier detection of fraility. As key deliverables for the NHS England Business Plan 14/15-16/17, he also discusses the implementation of a co-produced self management guide, tools to support personalised care planning and a House of Care toolkit as initiatives to help move frailty care away from hospitals and into the community.
Questions from delegates during our conferences always included concern about over-drugged elderly relatives who appeared to be unwell.
Dr Andrew Herxheimer a colleague and speaker always recommended a 'Therapeutic Audit' However it was not always easy for people to obtain referral to a Geriatrician and concerned pharmacists complained GP's did not always address their concerns.
As another colleague and speaker Professor Heather Ashton states there is need to gradually reduce the dosage of addictive medications such as benzodiazepines and Z drugs. These drugs affect cognition leading to memory loss and are linked to falls. The cost of supported gradual withdrawal from benzos, pain killers and antidepressants no longer indicated due to harm exceeding benefit, would be less than the cost to the NHS of emergency A & E admission due to accidents, plus the increase in iatrogenic illness caused by harm from medication including overprescribed statins.
Analysis of hospital admissions published in the RSM journal showed an increase in admissions to A & E due to ADRs over a period of10 years, had risen by 76.8% .
Hopefully Professor Young's initiative will lead to improved education for GPs in the area of recognition of ADRs. and iatrogenesis.