Multidisciplinary assessment is needed

EDITOR—Long term care of frail elderly people remains neglected, as Turrell et al point out.1 A key factor in balancing demand, needs, and supply, and in the appropriate use of resources, has been the gatekeeping role of effective multidisciplinary assessment. In many areas the quality of this assessment has been undermined by the lack of a thorough medical review of older people.

A recent joint audit involving social and health agencies looked into the assessment process over six months, for a base population of 26 000. Thirty three patients were identified as needing institutional care and requiring local authority finance. Only nine of 17 patients in the community had had any form of documented medical assessment, though this is viewed as mandatory by community care legislation.2 Opportunities for intervention and rehabilitation may well have been missed, and …