An audit of clinical dependency in geriatric continuing care.

1,376 elderly patients in 16 separate geriatric medical continuing care facilities, in greater Glasgow, including an NHS funded partnership nursing home, were surveyed over a six month period. This provided a snapshot of physical and mental dependency, specialist medical and nursing requirements and suitability of placement. The survey confirmed an extremely dependent population, with 82% scoring eight or less on a modified Barthel scale (maximum score 20) and 79% thought to require ongoing consultant supervision. Not all of the latter group were in the most dependent category. Forty one per cent of patients received specialised pressure relieving equipment and 30% had had a major adverse medical event in the six months prior to survey. Eighty-eight per cent of cases had had formal consultant review in the previous month. Currently there is a small group of patients resident within NHS continuing care facilities who might be cared for elsewhere. There is a larger group who need specialised care, they are characterised by a need for specialised nursing skills, regular medical review and consultant supervision.