Frail & Elderly

Despite the Covid-19 epidemic, the multidisciplinary frailty and complex care team is continuing its work with across the borough for all frail elderly people, and those with complex needs.

  • Add patients at high risk of unplanned admission or with complex needs to the practice frailty register and refer to the Complex Care Nurse to help manage the patient – they will triage the patient remotely initially.
  • The neighbourhood MDMs continue virtually from 9.30 to 11.30am. GPs and Practice Nurses are encouraged to discuss patients. Please email before the MDT meetings.
    • NW3 Neighbourhood – every 3rd Wednesday
    • South & CHE(S) – every 3rd Wednesday
    • NW5 Neighbourhood – every 4th Wednesday
    • CHE (W) – every 4th Wednesday
    • Borough – 1st, 2nd and 5th (if there is one) Wed 09:30–11:30 with a small number of participants at Keats Group Practice
  • All referrals to the MDM should be sent by 14:00 on the Tuesday before the meeting each week to
  • Care navigators are available in practices, supporting vulnerable older people to get the right care, and will also help facilitate food parcel deliveries.
  • 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).


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