Emergency medical admissions and the effect of Covid -19 in those with Parkinson’s disease at a small district general hospital, Scope of service and Care of the Elderly involvement

I was appointed as a substantive care of the elderly consultant at east Cheshire NHS Trust approximately 1 year ago. The trust has one of the smallest district general hospitals in the country – Macclesfield District General. Prior to me joining the trust, there were some historical difficulties with recruitment of COTE consultants to the department. This resulted in reduced capacity within the COTE department and many services that COTE used to be involved in had to be reduced back. This included the COTE involvement in the movement disorder service and the relationships with the Parkinson’s disease nurse specialists. In the last year, recruitment has been much more successful and there are now 3.5 COTE consultants. This means our service can start to slowly expand again.

Part of my job plan includes sessions within the acute frailty service. As a result of this, I have developed relationships with the visiting neurologists and newly appointmented Parkinson’s nurses. I have expressed an interest in looking at how COTE could be involved in the service again and in supporting inpatients and outpatients living with movement disorders and frailty.

Working at the front door of the hospital, it has become apparent that many patients living with Parkinson’s are being admitted on the acute medical take and that no advice, support and guidance is available to these patients from the PD nurses once they are admitted. The numbers of complex Parkinson’s patients presenting with frailty syndromes and on the acute take seems to have increased and I wanted to see whether this was accurate.

The aim of my project was to gather some information and data to look at the need for specialist movement disorder input into the acute trust’s inpatients and to establish in more detail whether there is a role for COTE within the existing service.