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. Please email before the MDT meetings to confirm the venue, as these sometimes change.
- 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 (see Downloads).