The CCG frailty team is continuing its work to integrate services across the borough for all frail and elderly people.
- Add patients at high risk of unplanned admission to the practice frailty register and refer to the Complex Care Nurse to help manage the patient.
- The Neighbourhood MDTs have now started (see below and see Downloads for the list of practices and timetable). GPs and Practice Nurses are encouraged to visit and discuss patients.
- NW3 Neighbourhood – every 3rd Wed at Hampstead Group Practice
- South & CHE(S) – every 3rd Wed at South Camden Centre for Health
- NW5 Neighbourhood – every 4th Wed at Parliament Hill Surgery
- CHE (W) – every 4th Wed at West Hampstead Medical Centre
- All referrals to the MDT should be sent before 14:00 on the Tuesday before the meeting each week to email@example.com.
- Care navigators are available in practices, supporting vulnerable older people to get the right care.
- There are four education modules that can be completed – GP Education Frail & Elderly. Upon completion, a certificate will be issued.
For more information about prevention of falls, please refer to the Camden Integrated Network Checklist.
View the Presentations from the Frail & Elderly session on 22 September 2016.