posted 20 June, 2018

Elderly Medicine

Many of our services are delivered in the community, making it easier for elderly patients to access care.

This includes Rehabilitation, Nursing Home Case Management, NHS Continuing Care long stay beds, and community services to support recently discharged patients or those at risk of hospital admission.

The services MFT provide to elderly patients are extensive and include assessment and treatment for older patients who are acutely unwell, who have suffered a stroke or TIA, have dementia, or Parkinson’s disease or another movement disorder. Services we provide also include:

Bone Health Service

For patients with osteoporosis and related disorders. The team has full access to bone density scanning (DEXA) where needed and a strong emphasis on patient advice and holistic care. Injectable medicines can be administered in the clinic where needed. A telephone advice line offering ongoing support is also available for current patients.

Falls and Syncope Service

Comprehensive assessment and treatment for patients who have balance disorders or are having falls or unexplained blackouts and collapses. Causes can include fainting, inner ear problems, low blood pressure or anxiety. The team includes medical staff, nurses and physiotherapists, and many patients are seen by a podiatrist to identify foot disorders. It is a key priority to identify patients who have, or are at risk of, osteoporosis and may need referral for bone densitometry (DEXA) scanning. The team also has access to the full range of cardiology, radiology, neurology and laboratory investigations including tilt table testing where needed.

Orthogeriatrics

Defined as the care of elderly orthopaedic inpatients, most often following a fractured hip. We provide a consultant-led orthogeriatric service supported on the ward by a specialty registrar (SpR). Our aim is for a consultant to review all patients on the trauma wards within Orthopaedics who have suffered a fractured hip within 72 hours of admission, with a focus on ensuring surgery can take place as soon as appropriate. Bone health and risk of further falls are also assessed. We work to ensure patients are discharged as soon as possible with appropriate support.

General surgery

We offer a consultant geriatrician-led service providing medical support to patients aged over 65 admitted under the care of general surgery with either complex medical problems or functional dependency. These patients are reviewed with the aim to optimize their condition and ensure timely surgery (if appropriate). Ongoing medical support and advice is provided following their operations or on request from the surgical team.

Facilities

Acute Inpatient Wards

The department has three wards for elderly patients with acute and complex medical problems and a dedicated Stroke Ward. Most patients are admitted through the Emergency Department or the Acute Medicine Unit. All patients have a named consultant who performs reviews at least twice weekly. Daily reviews by the ward medical teams also take place.
Patients receive visits from physiotherapists and therapy assistants, occupational therapists, pharmacists, social workers, the mental health team, dieticians, speech and language therapists, and the palliative care team.

OPAL House Discharge to Assess Unit

This unit is located on Southmoor Road opposite the main Wythenshawe Hospital site and is specifically for patients who no longer need acute hospital care and are considered to be medically stable to leave the hospital but require a further period of assessment prior to discharge. Further details are available here.

Outpatient clinics

Patients with general medical and elderly medical conditions, as well as those with non-acute stroke issues, can be seen at Buccleuch Lodge Day Hospital, Withington. Referrals are accepted on e-referrals, by letter to the Day Hospital, or by faxing 0161 217 4252.

Day Hospital

Patients who need assessment for falls and syncope and movement disorders including Parkinson’s Disease, are seen at the Day Hospital.

The Community Day Hospital, based at Buccleuch Lodge on the Withington Community Hospital site, offers a full service for patients needing assessment by a range of health professionals. Patients can be seen on an urgent basis where needed and we aim to see all referrals within one week. Therapeutic services range from one-to-one rehabilitation work to group exercise classes. We provide a bone health service including DEXA scanning and injection therapies for osteoporosis. Elective blood transfusions can be provided within the Day hospital. We also have a Frailty and Admissions Avoidance service for frailer patients needing rapid assessment and support to prevent hospital admission.

The unit accepts direct referrals from GPs, community services and others for patients from all areas. Ambulance transport can be arranged on a needs basis if necessary.

Home (Domiciliary) Visits

We are not currently commissioned to perform domiciliary visits for South Manchester. However in South Manchester geriatrician reviews can be requested through the South Manchester Single Point of Access by calling: 0161 946 8333.

The South Trafford Community Geriatrician scheme offers geriatrician reviews via GP referral to Trafford care home residents. The service works closely with the Trafford Community Matron and the Trafford Parkinson’s Disease Nurse Specialist. For further details, please call: 0161 291 6361.

For patients who are resident in other areas, domiciliary visits will be considered on an individual basis. Please contact the department to discuss by calling: 0161 291 6374.

Joint Working

The department also has links to other areas of the hospital:

Emergency Department – The OPAL Team (Older Persons Assessment and Liaison) provides a five-day a week geriatrician-led multidisciplinary service within the Emergency Department. The team reviews those patients who could potentially return home (often with increased support) and provides early and comprehensive assessment of frailty syndromes. This specialist service helps to prevent unnecessary admissions. The team liaises closely with the community services, patients’ relatives and carers, to reduce the chances of re-admissions.

Acute Medicine unit – The OPAL team also works seven days a week on the AMU (Acute Medical Unit). This assessment unit is usually where patients spend the first few days of their hospital admission. The team provide early specialist input and advice for the older person including therapy and pharmacy review. The team ensure early discharge if safe to do so with input from community services.

Contacts

We are always happy to discuss referrals.
Main department – Phone: 0161 291 6374 Fax: 0161 291 6075
Day Hospital – Phone: 0161 217 4250 Fax: 0161 217 4252

OPAL House Discharge to Assess Unit

This unit is located on Southmoor Road opposite the main Wythenshawe Hospital site and is specifically for patients who no longer need acute hospital care and are considered to be medically stable to leave the hospital but require a further period of assessment prior to discharge.  Further details are available here: link to https://mft.nhs.uk/wythenshawe/services/opal-house/