Seen the doctor on the Tele? Patient centred care needs to arrive for all, and none more urgent than for our older patients

Chris Subbe is a Consultant in Acute, Respiratory & Critical Care Medicine. He is a Service Improvement Fellow with the Health Foundation. He does research on patient safety at Bangor University. He tweets @csubbe

Unsurprisingly many of us have more medical needs as we get older. While some people manage to stay remarkably fit, for others it is getting more difficult to get around town or worse across country. The hike around an overflowing car park of an inner-city hospital does surprisingly little for mobility, and most people get little value from sitting in an outpatient waiting area to wait while their medical team is struggling with the application of queuing theory to healthcare.

A few years ago, when granddad was sent a follow-up appointment for his cardiac surgery several months after the operation, I was suspicious. I rang the secretary of the colleague who had done an amazing job on his heart to ask for the reason for the review. “An important part of quality assurance: we like to make sure that everything has gone well”. I explained that granddad had been in hospital, survived prolonged rehabilitation, and had already been followed up by an excellent local geriatrician and one of our brilliant cardiologists. He felt well. I suggested cancelling the appointment.

Care centred around the patient: discontinuing the lack of continuity of care

Dr Mark Temple is the Future Hospital Officer at the Royal College of Physicians (RCP), overseeing the implementation of the Future Hospital Programme. The aim of the programme is to take the recommendations of the Future Hospital Commission report from page to clinical practice. The BGS is a partner supporting this programme.

While being interviewed by BBC Radio 5 Live, recently, I was rendered speechless by an angry carer whose elderly mother had moved wards five times during an acute admission, one of which included a transfer to a different hospital site. This is indefensible.

Lack of continuity of care is the number one concern amongst physicians. Patients and carers express this as a lack of ‘joined-up’ care, characterised by multiple ward moves and general bewilderment about ‘who is in charge?’

The RCP’s Future Hospital Commission report identified that the frail older patient with multiple co-morbidities is now the NHS’ ‘core business’. Sadly, examples of these patients’ needs not being met by consistent standards of care, including continuity of care, are all too readily available.