Intended for healthcare professionals

Feature Care of Older People

Welcome to the emergency department exclusively for the over 80s

BMJ 2020; 368 doi: (Published 11 March 2020) Cite this as: BMJ 2020;368:m931
  1. Sophie Arie, freelance journalist
  1. London
  1. sophiearie{at}

Sophie Arie hears from specialists in geriatrics about a new unit designed to relieve pressure on emergency departments and provide better care for older patients with urgent needs

The corridors are wide, and there’s an atmosphere of calm. The space is full of natural light and designed with long, clear lines of vision to reassure the patients—all of whom are over 80. There are six beds, some in single rooms; an adjacent ambulatory ward; and a “therapy room” where patients, relatives, and staff can have private conversations. Hot meals and cups of tea are served regularly, and nurses take the time to chat and help people get to the toilet, of which there are a generous three.

Yet this is not a geriatric ward or palliative care unit. It’s the Older People’s Emergency Department (OPED) at the Norfolk and Norwich University Hospital, where older patients needing urgent or emergency care are seen by a consultant geriatrician, given a comprehensive geriatric assessment within two hours of arrival, and treated and cared for by a multidisciplinary team.

Compared with the hospital’s windowless (and often hectic and noisy) 16 bay emergency department only 20 metres down the corridor, with its sometimes drunk and distressed patients all sharing a single toilet, this is a haven of tranquillity.

“It’s great. It’s just what we want for old people,” says Sarah Bailey, OPED’s lead consultant geriatrician. Bailey helped set up the unit, which opened in 2017, to provide specialised care for the growing number of elderly emergency patients at the hospital.

Since its opening OPED has proactively sought out patients in the emergency department or elsewhere in the hospital who could benefit from its services. Increasingly, the unit also advises Norfolk’s GPs, care homes, and paramedics by phone to help them assess potential patients and admit …

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