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DoLS: Bureaucratic, costly and badly in need of reform


It started with coffee in the lounge of the most exclusive and opulent club in the UK, the House of Lords. I was there meeting Baroness Elaine Murphy and Professor David Jolley – two old age psychiatrists who share my passion for better care of older people with mental illness. We had a meeting with the Law Commission later that morning about a planned revision to the Deprivation of Liberty Safeguards (DoLS) legislation, so we had arranged this get-together, amongst the oak panelling and the portraits, to plan what we were going to say…
Continue reading “DoLS: Bureaucratic, costly and badly in need of reform”

You can’t fatten a pig by weighing it


I worked exclusively for the National Health Service (NHS) for 30 years before combining my NHS post as a consultant old age psychiatrist with a part-time medical directorship in the private sector. Six months ago I joined Red & Yellow Care (R&YC), a private healthcare provider specialising in dementia and other long-term conditions prevalent in old age. Although R&YC and most NHS services provide first class clinical care, there are organisational differences, and none greater than the difference in operational efficiency.

Bureaucracy and excessive recording of data fetters the NHS. When I looked into this in my own NHS practice I found that for each hour a team member spent with a patient, they would spend two in front of a computer. This problem is widespread in the NHS. At R&YC this ratio is reversed, while quality is nothing short of excellent.

Contrary to popular belief, private practice is Continue reading “You can’t fatten a pig by weighing it”

Opening our doors to more people in dire need of better care


A while back a patient, her husband and son invited me for tea. It was a privilege to converse with this charming and hospitable family, and it was very insightful to receive first hand feedback on Red & Yellow Care’s service provision.

The husband thanked us for the bespoke and responsive nature of our service. His wife had needed a range of assessments and tests, and each appointment had been organised within a matter of days and with a high degree of flexibility. The initial referral was on a Monday, a home visit by one of our consultant psychiatrists on Tuesday evening, a blood test on Thursday, a follow-up consultation with a consultant geriatrician on Saturday, an MRI scan the following Thursday morning, the outcome of the scan communicated by phone that same day and the full diagnostic report sent by the following Monday. The entire Continue reading “Opening our doors to more people in dire need of better care”

Women and dementia


The newly published Report Women and Dementia provides the first official recognition that dementia disproportionately affects women. This imbalance arises as a result of it being women who do most of the caring (both as family members and as paid staff), and also because age is the major risk factor and more women live longer than men. While in truth I can’t think of why it has taken so long for this thinking to be documented, I welcome the report in finally drawing much needed attention to this marked gender imbalance.

From relative obscurity half a century ago, with the Prime Minister making it a priority at the G7/8 meeting in 2013, dementia has really shot up the national agenda. The successful Dementia Friends and Dementia Friendly Communities campaigns led by the Continue reading “Women and dementia”