Problems in the delivery of medical care to the frail elderly in the community

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Abstract
Describes how closure of hospital long‐stay wards for the frail elderly and their replacement by care in the community has led to a mismatch of skills and patients. Restrictive practices within the medical profession, and rigid adherence to the existing referral system from general practitioner to hospital consultant can operate against the interests of patients in the community. Some means must be found to bring skilled medical care to patients in residential and nursing homes. If this cannot be achieved within existing NHS structures, local authorities and the private sector should consider appointing their own consultants to liaise with NHS personnel as necessary.