Huisarts en specialist ouderengeneeskunde voorop

The Dutch National Care for the Elderly Programme (NPO) was launched as a large-scale project, in which screening for vulnerability, followed by a comprehensive geriatric assessment, played an important role. An oft-cited explanation for the poor effects of the NPO projects is the high quality of Dutch primary care. However, the complexity of frail elderly care raises the question as to whether the competence of a nurse or practice nurse is sufficient to ensure proper care and treatment. Moreover, studies used vulnerability as a risk status, as if vulnerability were reversible. Medical care for the frail elderly needs instead to be patient-centred and encompass jointly established goals. This approach offers opportunities to reduce unwanted hospitalisations and referrals to secondary care. This view underlies the University Practice Elderly Care Medicine, where general practitioners and specialists in elderly care medicine collaborate in the care and treatment of vulnerable elderly patients, and satisfaction, continuity of care and concerns of compliance with life goals are the outcome measures.