{"id":4149,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/moeeastlothian\/"},"modified":"2025-06-02T15:06:13","modified_gmt":"2025-06-02T14:06:13","slug":"moeeastlothian","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/moeeastlothian\/","title":{"rendered":"MoE East Lothian"},"content":{"rendered":"\n<h4 class=\"wp-block-heading\">\u200bInformation <\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">For patients with frailty, dementia or delirium, avoidable admission to hospital can be detrimental to both physical and mental health.&nbsp; Patients loose 10% of their body mass per week on bed rest or with minimal activity as is common in hospital.&nbsp; In addition, change of environment can worsen cognitive and behavioural issues in those with dementia or delirium.&nbsp; For some patients admission to hospital is still the most appropriate course of action but this document outlines alternatives sources of support and treatment available to prevent this where possible.<\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<figure class=\"wp-block-table\"><table><tbody><tr><td><em><strong>Patient need\/ type of service required:<\/strong><\/em><\/td><td><em><strong>Team to refer to:<\/strong><\/em><\/td><td><em><strong>Who can refer:<\/strong><\/em><\/td><td><em><strong>How to refer:<\/strong><\/em><\/td><\/tr><tr><td>PT and OT requirement where urgent assessment, equipment and support could prevent a hospital admission<\/td><td><strong>Integrated Rehabilitation Team<\/strong><\/td><td>Any health professional<\/td><td>East Lothian Rehabilitation Service Point of Contact 01620 642834&nbsp;<\/td><\/tr><tr><td>Acute medical needs +\/- therapy needs as an alternative to hospital admissionPriority is given to patients with complex care needs and frailty&nbsp;Patient requires to be safe at home and patient\/ family happy for acute medical care under H@H<\/td><td><strong>Hospital@Home<\/strong>(have access to urgent therapy if needed so no need to refer additionally to IRT)&nbsp;<\/td><td>Any health professional who has had training in advanced clinical assessment&nbsp;<\/td><td>Referrals via Patient Flow Centre 0300 013 4000(option 1 and then option 4)&nbsp;For further guidance see our Ref Help Page:<a href=\"\/refhelp\/guidelines\/HospitalAtHomeEastLothian\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/HospitalAtHomeEastLothian.aspx<\/a>&nbsp;<\/td><\/tr><tr><td>Non-acute medical issues, could attend as outpatient<\/td><td><strong>ELCH Geriatric Medicine\/ Parkinson\u2019s Clinic<\/strong><\/td><td>GP practice\/ hospital clinicians<\/td><td>Refer via SCI-GatewaySee resources for additional guidance<\/td><\/tr><tr><td>OT assessment only required&nbsp;<\/td><td><strong>Community occupational therapy<\/strong><\/td><td>Any healthcare professional<\/td><td>East Lothian Council Contact Centre 01875 824309<\/td><\/tr><tr><td>Physiotherapy assessment only required<\/td><td><strong>Domiciliary Physiotherapy team<\/strong><\/td><td>Any healthcare professional<\/td><td>Refer via SCI-Gateway for East Lothian Physiotherapy<\/td><\/tr><tr><td>Concerns regarding swallowing or communication issues<\/td><td><strong>Speech and language therapy<\/strong><\/td><td>Referral accepted from anyone (usually via GP)<\/td><td>SCI Gateway \u2013 AHP Speech and Language Therapy<a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/speechandlanguagetherapy\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/speechandlanguagetherapy\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/apps.nhslothian.scot\/refhelp\/SpeechTherapy\/SpeechTherapyAdult<\/a><\/td><\/tr><tr><td>Community dietetics&nbsp;<\/td><td><strong>Community dietetic team<\/strong><\/td><td>Any health professional<\/td><td>Refer via SCI Gateway for AHP &#8211; Dietetics East Lothian<a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/dietetics\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/dietetics\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/apps.nhslothian.scot\/refhelp\/Dietietics<\/a><\/td><\/tr><tr><td>Increasing care needs in the community &#8211; urgent, at risk of admission to hospital<\/td><td><strong>East Lothian Contact Centre (ECS)<\/strong>&nbsp;<\/td><td>Referral accepted from any healthcare professional or members of the public<\/td><td>Refer via East Lothian Contact Centre 01875 824 309&nbsp;<\/td><\/tr><tr><td>Increasing care needs in the community \u2013 non-urgent<\/td><td><strong>East Lothian Contact Centre (ECS)<\/strong>&nbsp;<\/td><td>Referral accepted from any healthcare professional or members of the public<\/td><td>Refer via East Lothian Contact Centre 01875 824 309<\/td><\/tr><tr><td>Patient requiring a community bed for end of life care (Ward 1 ELCH, Ward 3 Belhaven, Edington)<\/td><td><strong>East Lothian Patient Flow Team<\/strong>&nbsp;<\/td><td>Any healthcare professional<\/td><td>Referral by telephone01620 642 795\/6<a href=\"\/files\/sites\/2\/East-Lothian-Patient-Flow-Team-Referral-Guide.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">East Lothian Patient Flow Team Referral Guide.pdf<\/a><\/td><\/tr><tr><td>Patients over the age of 65 who require assessment and treatment for mental health conditions, including cognitive impairment.<\/td><td><strong>East Lothian \u2013 Psychiatry of Old Age<\/strong><\/td><td>General and other medical practitioners from other services<\/td><td>Refer via SCI Gateway<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" \/>\n\n\n\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Falls and frailty syndromes including dizziness<\/li>\n\n\n\n<li>Weight loss in frail older patients<\/li>\n\n\n\n<li>Multiple\/complex symptoms in frail<\/li>\n\n\n\n<li>Single symptom suggestive of malignancy if frail (consider if single organ specialty referral more appropriate especially if clinical frailty score &lt;4)<\/li>\n\n\n\n<li>Possible Parkinson&#8217;s disease (please state this in the referral)<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Iron deficiency anaemia (single issue) \u2013 should be referred to GI<\/li>\n\n\n\n<li>Memory loss only \u2013 should be referred to Memory Clinic \/ Old Age Psychiatry in East Lothian<\/li>\n\n\n\n<li>Polypharmacy reviews \u2013 Integrated Care Pharmacists in GPs can help with this<\/li>\n\n\n\n<li>Incontinence \u2013 consider continence nurse \/ DN referral<\/li>\n\n\n\n<li>End of life support &#8211; palliative care team unless require community bed in which case please refer via East Lothian Patient Flow Team (see above)&nbsp;<\/li>\n\n\n\n<li><strong>ALL the above do not preclude the referral being appropriate \u2013 clinical judgment is required. We are more than happy to discuss referrals\/give advice.&nbsp;<\/strong><\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\">We are currently developing specific guidance for conditions affecting older people:&nbsp;<a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/medicineoftheelderlygeriatrics\/\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/medicineoftheelderlygeriatrics\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/apps.nhslothian.scot\/refhelp\/MedicineofElderlyGeriatrics<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Osteoporosis guidelines:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"\/refhelp\/guidelines\/Osteoporosis\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/Osteoporosis.aspx<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Parkinson&#8217;s Disease referral guidelines:&nbsp;<a href=\"\/refhelp\/guidelines\/Parkinsons-(MoE)\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/Parkinsons-(MoE).aspx<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">TIA and stroke referral guidelines:&nbsp;<a href=\"\/refhelp\/Neurology\/TransientIschaemicAttackTIAAndStroke\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/apps.nhslothian.scot\/refhelp\/Neurology\/TransientIschaemicAttackTIAAndStroke<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"\/files\/sites\/2\/East-Lothian-Patient-Flow-Team-Referral-Guide.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">East Lothian Patient Flow Team Referral Guide.pdf<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Frailty_Information_Resource.pdf\" data-type=\"link\" data-id=\"https:\/\/scottish-my.sharepoint.com\/:b:\/g\/personal\/aparna_amanna_nhslothian_scot_nhs_uk\/ERfxdTzLxLVIhIkyCw87HkkBvJGAKkIhekvq67XJsQvseQ?e=wBfPg4\" target=\"_blank\" rel=\"noreferrer noopener\">Frailty Information Resource<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/FRAILTY-POSTER.pdf\" data-type=\"link\" data-id=\"https:\/\/scottish-my.sharepoint.com\/:b:\/g\/personal\/aparna_amanna_nhslothian_scot_nhs_uk\/EdoxOd40npZApY2i_0bPSUIBeMfGyftUaOWjvGPVXypq9Q?e=vDpZQz\" target=\"_blank\" rel=\"noreferrer noopener\">Frailty Poster <\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>&#8203;Information For patients with frailty, dementia or delirium, avoidable admission to hospital can be detrimental to both physical and mental health.&nbsp; Patients loose 10% of their body mass per week on bed rest or with minimal activity as is common in hospital.&nbsp; In addition, change of environment can worsen cognitive and behavioural issues in those<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3664,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[310],"class_list":["post-4149","page","type-page","status-publish","hentry","category-moe-east-lothian"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/medicineofelderlygeriatrics\/medicine-of-the-elderly-services\/moe-east-lothian\/\" rel=\"tag\">MoE East Lothian<\/a>","rttpg_excerpt":"&#8203;Information For patients with frailty, dementia or delirium, avoidable admission to hospital can be detrimental to both physical and mental health.&nbsp; Patients loose 10% of their body mass per week on bed rest or with minimal activity as is common in hospital.&nbsp; In addition, change of environment can worsen cognitive and behavioural issues in those","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4149","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4149"}],"version-history":[{"count":7,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4149\/revisions"}],"predecessor-version":[{"id":24162,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4149\/revisions\/24162"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3664"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4149"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4149"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}