Current services for Medicine for the Elderly in West Lothian
SCI gateway single point of contact referral for non-urgent
REACT for urgent 01506 524149
Referral should be based on patient’s postcode, not GP Practice
REACT Hospital at Home (H@H)
Acutely unwell frail, older peopleAlternative to hospital admissionShort term (few days)Comprehensive geriatric assessment at home (inc care home) in the acutely decompensated
Phone call to REACT hub 01506 524149 if urgent (same day/next day) visit required – clinical conversation is usefulNot an alternative to a GP visit.SCI gateway referral if able to wait 2-3 days for assessment.
REACT Rehab (AHPs)
AHPs only – physio and OTFull assessment at home (inc care home for physio)
Phone call to REACT hub (01506 524149) if urgent (same day/next day) visit requiredSCI gateway referralSt Johns Hospital > REACTH@H will often refer during/ on discharge from H@H
REACT Rapid Access Clinic
We triage to home visits, face to face clinic, and phone/video as appropriate. Please make clear if patient could physically come to clinic.We will refer to AHPs if needed
SCI gateway referralSt Johns Hospital > REACT We aim to see within 2 weeks.
Centralised stroke/ TIA hotline available for GPs to obtain immediate advice and appointments organised- please see the RefHelp page 0131 536 1019
St Michael’s HospitalLinlithgowTippethill House Hospital, Armadale
Hospital Based Complex Clinical Care (HBCCC)Palliative care for West Lothian patients. *Please refer to community hospitals Pathway for referrals to community hospitals opens a new window/ inclusion criteria (Please discuss with patient / family. Clear anticipatory planning / escalation of care conversation needed before referral.Patient not for transfer to acute sector for diagnostics/interventionNot requiring daily specialist consultant palliative care input)
Weekdays 9am-6pmIf community hospital admission required, please refer to REACT 01506 524149 stating that assessment required for admission.REACT will assess if appropriate.
Frail older people in need of secondary care assessment
Single point of contact – SCI referral for all but urgent (triaged daily)
Same day / next day urgent assessment should be via REACT H@H and discussed with REACT coordinator (i.e. referral is to avoid hospital admission)
Geriatrician is available for advice via above
Please include question to be answered and if possible rockwood_cfs opens a new window clinical frailty score (or equivalent assessment of frailty) as this helps us to triage to correct service.
Who to refer:
Appropriate referrals for REACT/rapid access/general MOE clinic (equivalent) assessment (excl stroke and PD):
Falls, frailty syndromes including dizziness
Weight loss in frail older patients
Multiple/complex symptoms in frail
Single symptom suggestive of malignancy if frail (consider if single organ specialty referral more appropriate especially if clinical frailty score <4)
Who not to refer:
Weight loss in non-frail patients (ie clinical frailty score <4) – should be referred to General Medicine in West Lothian
Iron deficiency anaemia (single issue) – should be referred to GI in West Lothian
Memory loss only – should be referred to Memory Clinic / Old Age Psychiatry in West Lothian
Polypharmacy reviews – Integrated Care Pharmacists in GPs can help with this
Some indication of frailty – functional status/baseline and POC/family support is most helpful. Clinical frailty score also helpful.
What is the aim of referral and what are the patient and family’s expectations. (i.e. if frail patient not for investigations of possible malignancy – what is it that is hoped the referral will achieve?)
Alternatives to referral / advice
Email and/or phone advice always available
Telephone via REACT – coordinator initially – ask for consultant geriatrician if needed
