Clinical gerontology
What we do
The Department of Clinical Gerontology (DCG) is based at King’s College Hospital and provides specialist inpatient and outpatient care for older people living with frailty.
We diagnose and treat conditions that are common in older, frail people. We support patients with a wide range of health needs, including falls, memory problems, frailty, and complex long-term conditions.
Our team of doctors, nurses, therapists, and other healthcare professionals work together by carrying out a Comprehensive Geriatric Assessment (CGA) to assess each patient’s needs and develop a personalised care plan.
We aim to help patients maintain their independence, improve their physical and mental health, and achieve the best possible quality of life. We work closely with colleagues in Old Age Psychiatry and social services, as well as in the charity sector.
A specialist frailty team ensures that vulnerable older people living with frailty are seen within the first few hours of their arrival at the Emergency Department (ED) at King’s College Hospital (KCH).
Our team of doctors, nurses, and therapists work with the ED team, social workers, and community teams to ensure a CGA is delivered as early as possible, and that, where possible, ongoing care can be provided in the community to avoid unnecessary hospital admissions.
Where admission is needed, we aim to look after patients living with frailty on our short-stay Frailty Assessment Unit (FAU), which includes both a Same Day Emergency Care (SDEC) area, and 24-hour beds. On FAU, we aim to support appropriate discharge as soon as possible, ensuring patients who need ongoing community care are supported.
For patients who need ongoing inpatient care, we have three inpatient wards for older adults: Donne, Marjory Warren, and Byron wards. Together, these wards form our Health and Ageing Unit (HAU) in the Ruskin Wing, offering inpatient medical care and rehabilitation.
We work closely with patients, families, carers, and community services to ensure care is co-ordinated both during a hospital stay, and at transfer from hospital.
We run outpatient clinics in the King’s Older Persons’ Assessment Unit (KOPAU), also known as the Betty Alexander Suite, located in Suite 2, Golden Jubilee Wing. Our focus is on providing compassionate, person-centred care that supports older people to live as independently and safely as possible.
We recognise that frail patients may be looked after by other specialists at King’s, and we support this in a variety of ways:
- our In-reach Frailty Team covers acute and post-acute medicine
- our PROKARE team supports general surgery, trauma and orthopaedics, and neurosurgery
These teams screen older adults for problems associated with frailty and offer, clinical assessment, CGA, advice and support. They can organise transfer of care to our HAU as needed. They also offer advice and support to other specialities, including renal, oncology, haematology, and cardiology.
The department conducts research, carried out from the Clinical Age Research Unit (CARU), an internationally recognised centre for studying the process of ageing.
Preparing for your appointment
Please bring an up-to-date list of your medicines with you, including non-prescription tablets or herbal medicines.
Location
Suite 2, Ground Floor, Golden Jubilee Wing, King’s College Hospital, Denmark Hill, London, SE5 9RS
Contact Details
- Main Reception (Outpatients): 020 3299 6185
Conditions we treat
Our outpatient service sees patients who have:
- heart failure with co-morbid frailty
- dementia, cognitive impairment, and memory problems
- osteoporosis
- falls
- Parkinson’s disease and other movement disorders
- conditions that mean they are being optimised or considered for surgery or chemotherapy
- frailty affecting most or all aspects of other medical problems and/or function
- mobility or functional issues that need physiotherapy or occupational therapy involvement
Our team includes dedicated nurses who case-manage patients, act as patient advocates, and co-ordinate care working alongside doctors and therapists.
Occupational therapists assess a patient’s functional ability with maintained independence and safety at home as priorities. They can provide aids and minor adaptations as needed.
Physiotherapists provide screening, assessment, and management of patients at risk of falls and for those with mobility or balance problems. We provide group balance classes, as well as individualised assessments and other forms of rehabilitation or onward referral.
A patient can see the whole team or individual members of the team depending on their needs.
The King’s Older Persons’ Assessment Unit (KOPAU) also offers an infusion service. Our patients can attend for blood transfusions and, commonly, other intravenous therapies, such as intravenous iron and intravenous bisphosphonates.
Specific requirements before referring a patient
Heart failure (co-morbid frailty)
When referring patients with possible or probable heart failure, and significant comorbidity or severe frailty (as determined by e-FI scores), include NT-proBNP levels in the referral to ensure appropriate triage.
Osteoporosis
Where there are concerns about osteoporosis, refer patients over 70 to the osteoporosis clinic. Please include a calculated FRAX score and NOGG recommendation in the referral.
Routine referrals
GPs should refer via e-RS wherever possible. For queries about patients already known to our service, please email [email protected].
We have some capacity to see patients more quickly, typically within a fortnight, on a case-by-case basis. For this, GPs have a route to referral via the Consultant Connect telephone line 9am to 5pm, as well as being able to use this line for consultant geriatrician advice and guidance.
Internal referrals should be sent via Epic as an outpatient referral to Clinical Gerontology.
Emergency referrals, advice and guidance
For emergency referrals, Lambeth and Southwark GPs can call the Consultant Connect number and select the appropriate option. This service is available to all GPs in Lambeth and Southwark 24-hours a day, seven days a week.
Call this service to speak to a consultant to:
- avoid the patient attending the Emergency Department (ED) at King’s College Hospital through advice and guidance and/or discussion of alternatives to an ED conveyance or attendance
- arrange a ‘HOT’ appointment, which may be possible within the following few days but is more likely achieved within the following fortnight
- arrange timely access to complex case intervention, for example, a specialist gerontology outpatient clinic or a planned review by a named neighbourhood geriatrician who is embedded within a Frailty or Ageing-Well Integrated Neighbourhood Teams (INTs)
- ask for urgent advice which cannot wait for a routine advice a guidance request via e-RS
Any other health and care professional can call the King’s College Hospital switchboard and ask to be put through to the Frailty Consultant, 9am to 5pm, seven days a week, to discuss their patients.
GPs can also ask questions via e-RS advice and guidance. We aim to respond within 72 hours.
Referral forms
| Title | File Size | Link |
|---|---|---|
| King’s Older Persons’ Assessment Unit infusion-transfusion referral form | 39 KB |
Key Clinical Staff
| Name | Role |
|---|---|
| Dr Gitanjali Amaratunga | Consultant Physician |
| Dr Dan Bailey | Consultant Physician and Co-Chair Trust LGBTQ+ Network |
| Dr Catherine Bryant | Consultant Physician, FRCP (retired, honorary contract) |
| Dr Verity Bushell | Consultant Physician |
| Dr Mariaelena Giudici | Consultant Physician |
| Dr Sharmeen Hasan | Consultant Physician |
| Dr Ambika Irving | Consultant Physician |
| Dr Nicola Lochrie | Consultant Physician |
| Dr Dawn McIntosh | Consultant Physician |
| Dr Georgina Meredith | Consultant Physician |
| Dr Laura Mitchell | Consultant Physician |
| Miss Emma Ouldred | Lead Dementia and Delirium Specialist Nurse |
| Dr Rohan Pathansali | Consultant Physician |
| Dr Oenone Poole-Wilson | Consultant Physician and Department of Clinical Gerontology Clinical Lead |
| Dr Prashant Reddy | Consultant Physician |
| Dr Julie Whitney | Consultant Practitioner (Academic and Physiotherapist) |
| Miss Hannah Williamson | Lead Frailty Nurse Practitioner |
| Dr Dan Wilson | Consultant Physician and Acute Specialty Medicine Clinical Director |
| Dr Ying Yap | Consultant Physician |