Integrated Community Ageing Team (ICAT)

ICAT is part of Proactive Frailty and Complex Care Team (PROFACCT) in Islington and the ICAT is a consultant-led multidisciplinary team (MDT) specialising in Comprehensive Geriatric Assessments (CGA) for patients who are registered with an Islington GP.

This is usually carried out in the patient’s own home. Further investigations such as x-rays can be arranged in Whittington Hospital if required.

The ICAT geriatricians and specialist pharmacists also provide visits and support to patients in Care Homes in Islington.

The Team:

• Consultant Geriatrician
• GP with Specialist Interest in Geriatrics
• Patient Pathway Coordinators
• Frailty Lead Nurse and Advanced Clinical Practitioner (ACP)
• Specialist Nurses
• Specialist Occupational Therapist
• Specialist Physiotherapists
• Specialist Pharmacists
• Pharmacy Technician
• Therapy Technician

Lead managers

• Dr Ruth Law
• Dr Philippa O'Riordan

Further Information

What is a Comprehensive Geriatric Assessment (CGA)

This is a patient-centred approach involving a co-ordinated process designed to determine a frail older person’s medical conditions, mental health, functional capacity and social circumstances. From this, the team can formulate a clear plan for treatment, rehabilitation, support and long-term follow up.

1. Overview Assessment: All team members are trained to complete a basic subjective assessment across all geriatric domains. This is to find out if there are particular problems that require more detailed and specialist assessments.
2. Specialist Assessment: This is an in depth assessment by relevant members of the multidisciplinary team of issues identified from the overview assessment
3. Comprehensive Geriatric Assessment: Brings together the overview and specialist assessments to generate a patient-centred plan. The patient’s GP and the referrer if requested will be informed of outcome of assessment.

Patients we may benefit often present with the following:

• Recurrent hospital admissions
• Falls
• Polypharmacy and medicines management
• Decreased mobility
• Continence issues
• Increasing frailty
• Cognitive decline

Who to refer to ICAT for a CGA:

• Frailty score of 6 or above.
• Aged 65 years or older
• Younger frail patients may be accepted if appropriate following discussion via the ICAT Hotline (07920 756 995)
• Clients must be registered with an Islington GP (or 157 Medical Practice).
• Referrals are accepted from any health professional as long as the patient’s GP is made aware of the referral and agrees that an ICAT referral is appropriate.
• We also offer Proactive CGA's for patients with a frailty score of 6.

ICAT support to Islington Care Homes

The ICAT (Care Homes) consists of a Consultant Geriatrician and Specialist Pharmacists and aims to work with GPs and other community services to provide care for patients residing in care homes according to their wishes and needs.

Objectives

• Improve communication between secondary care and primary care for patients in care homes
• Maximise the number of days spent at home by reducing unnecessary hospital admissions and length of inpatient hospital stay
• Work closely with care home staff and support their education and development
• Work closely with allied GP practices to support ongoing professional development in complex geriatric case management

How to refer a patient to ICAT

• GPs: via the ICAT referral form on EMIS
• Email referral form to ICAT email address (whh-tr.ICAT@nhs.net)

For discussion of potential referrals, or to discuss complex cases and obtain advice from a consultant geriatrician, please call the consultant hotline. If a referral is indicated following discussion, the referrer will also need to send a referral by email or via EMIS.

Office: 020 7288 5326, 8am - 4pm

Telephone advice from a consultant geriatrician on medical problems of frail older patients, and to discuss appropriateness of referrals to the service.

Please note this service is only for Islington residents and for residents with an Islington GP (and those registered at 157 medical practice).

ICAT Admin team

• Pauleene Thomas, Patient Pathway Co-ordinator
• Selly Toyin, Patient Pathway Co-ordinator