It is essential that a specific triage service is core to all A&E services in my opinion. There is a modal (RAID) which saves £4 for every £1 spent. Furthermore, older people feel more vulnerable in A&E settings, and less able to advocate for themselves, especially if there is superadded delirium, dementia, depression or pain.
I think this type of attached service should be financed and managed by the acute trust rather than a mental health trust, as there tends to be a conflict of interest between protecting old age psychiatry beds and providing the best care for the person. in addition, mental health services do not have access to setting up immediate community service back up, which is easier for the acute trust to arrange.
Without a credible elderly assessment and diversion service any other LEAN provision is bound to fail in the current demographics.
I have to declare an interest, I am a Consultant in Old Age Psychiatry.
