Geriatrics

The Department of Elderly Care at Brighton and Sussex University Hospitals NHS Trust (BSUH) operates collaboratively across the Royal Sussex County Hospital (RSCH) and Princess Royal Hospital (PRH) sites. Our focus is on person centred, individualised care and our work is characterised by a multidisciplinary and holistic approach.

Royal Sussex County Hospital

The department consists of 8 consultant Geriatricians. We operate a front door ‘frailty service’ in A&E and the Acute Assessment Unit which enables frail older people to be assessed by Geriatricians and the frailty team at the time of admission. Beyond the acute admission, patients are cared for across four specialist elderly medicine wards, including an award-winning unit treating medical problems in patients with cognitive im-

pairment. Daily board rounds are carried out on each ward with the multidisciplinary team to enable early discharge planning and rehabilitation plans.

Princess Royal Hospital

At the Princess Royal Hospital, there is a ‘joint take’ of emergency admissions –both general medical as well as elderly patients. Elderly care is provided by 4 geriatricians across two wards including the specialist dementia unit. Our multiprofessional team works together closely and liaises with carers and families of patients in order to provide holistic care, rehabilitation and timely discharges. Trainees will gain experience in managing problems affecting older patients including frailty, multimorbidity, polypharmacy, falls, dementia, delirium and end of life care. There will be opportunities to attend specialty clinics, including the

GERIATRICS

daily Rapid Access Clinic for Older People (RACOP) and Parkinson’s disease clinics. Across both sites, the department comprises twelve consultants, eight registrars, eight F1 doctors and twelve F2 / SHO doctors.

Teaching

Each trainee will have a clinical supervisor to support their professional development. Patient safety is at the centre of our department – we hold monthly M&Ms and frequent ward based After Action Reviews to enable reflective learning. Quality Improvement Projects are encouraged and discussed at weekly departmental teaching on Thursday lunchtimes. Trainees will support the teaching of medical students working with the department, predominantly those in their 3rd and 5th year of training.

Research and audit

The department has a strong research base through and all trainees will be encouraged to participate in research projects. Research interests include antibiotic-associated diarrhoea, vascular compliance and better targeting of antidepressant therapy. There is an active audit program which trainees will be expected to contribute towards.

Stroke Medicine

The hyper acute stroke unit looks after patients across the whole stroke pathway, from acute presentation to discharge. We provide a consultant-led 24hour thrombolysis service and intraarterial thrombectomy (currently in hours only), as well as a 7 day a week TIA service. There is an active multidisciplinary team including nursing staff,

physiotherapists, occupational therapists, speech and language therapists, clinical psychology and social services. The unit is busy seeing around 700 stroke patients a year, with an average length of stay of 10-11 days. There are 6 dedicated stroke consultants. There are close links with A&E and the early supported discharge team. Complex inpatient stroke rehabilitation is provided at PRH (about 15% of our stroke patients are transferred here).