Delivering Integrated Care for Older People with Frailty

Care Talk, with the Kings Fund are hosting an exciting conference on 15th March looking at innovative ways to provide integrated health and social care to frail older people. This seems to be particularly relevant to the domiciliary care sector as we try to keep people at home and independent as long as possible.

As someone who is trying to coordinate integrated care for an elderly relative with multiple morbidities, I am keenly aware of the tensions between dignity and choice on one hand and keeping someone safe on the other.  I saw good integration in so far as the response in an acute episode was superb; the health care and social care has been excellent. Thereafter I have seen little evidence of integration and several examples of poor communication, one a visit from a social worker who knew nothing of the intervening activity resolving the acute health issue, and another where blood tests commissioned by the district team were not checked by the GP team. No criticism here, both teams have been superb, but clearly a communication and integration issue.

The day looks an exciting opportunity to share good practice and find useful ways to deal with this growing problem. The programme includes a presentation looking at ways in which the NHS are looking at new models of care and service redesign to embrace people with frailty. There is also a presentation around acute care for people with frailty. There will be presentations describing innovative new projects: a frailty pathway and the role of the voluntary sector; followed by an opportunity to work together in breakout streams and a closing panel session. I can't go but I certainly hope that the papers and outcomes from breakout sessions will be published. Innovation is certainly needed.