Medical aspects of
intermediate care
Report of a Working Party
FEDERATION OF MEDICAL ROYAL COLLEGES
Royal College of Physicians of Edinburgh
Royal College of Physicians & Surgeons of Glasgow
Royal College of Physicians of London
December 2002
Acknowledgements
The development of the guidelines was supported by an unrestricted educational grant from Procter and
Gamble and Merck Sharp & Dohme. The Guidelines Development Group have maintained complete editorial
independence from the sponsors and all members of the Guideline Development Group have provided the
Royal College of Physicians with details of any potential conflicts of interests.
Front cover illustration:
Specimens of trabecular bone from young (above) and elderly (below) vertebral bodies. Note the reduction in bone
mass and microarchitectural deterioration typical of osteoporosis in older people.
ii
© FEDERATION OF ROYAL COLLEGES OF PHYSICIANS
OF THE UNITED KINGDOM
Royal College of Physicians of Edinburgh
9 Queen Street, Edinburgh EH2 1JQ
Royal College of Physicians and Surgeons of Glasgow
232–242 St Vincent Street, Glasgow G2 5RJ
Royal College of Physicians of London
11 St Andrews Place, Regent’s Park, London NW1 4LE
ISBN 1 86016 176 6
Text editing and layout by the Publications Department
of the Royal College of Physicians
Typeset by Dan-Set Graphics, Telford, Shropshire
Printed in Great Britain by Sarum ColourView Group, Salisbury, Wiltshire
Contents
Members of the Working Party
iv
Foreword
v
Executive summary and recommendations
vii
1
Introduction
1
2 Development of intermediate care services
2
3 Current activity, resources and models
4
4 The organisation of medical care and training
7
5 Clinical governance and audit
10
Appendix 1: Standards on medical aspects of intermediate care
14
Appendix 2: Useful web references for intermediate care
16
References
17
iii
Members of the Working Party
Dr David Black FRCP (Chairman), Chair of Joint BGS/RCP Geriatrics Committee
Professor Sir George Alberti FRCP(Edin) FRCPath, Past President, RCP London
Professor Ca