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Dr Tom Downes National Clinical Director for Older People and Integrated Personalised Care

Organisation: British Geriatrics Society

  • Quality Improvement Fellowship
  • 6
Tom Downes

About me

Tom is a Quality Improvement Fellow and National Clinical Director for Older People and Integrated Personalised Care at the British Geriatrics Society.

Tom completed medical training at Guy's Hospital, London, in 1993 and started his career as a General Practice trainee before entering specialist training in Geriatric Medicine. He was appointed Consultant Geriatrician and Honorary Senior Lecturer at Sheffield Teaching Hospitals in 2003.

Having grown up with a father working as Managing Director of an industrial company, Tom realised early in his career that a combination of medical and business training had the potential to provide a powerful skill set for healthcare improvement.

Tom studied at Nottingham University Business School and gained an MBA in 2003. His clinical work involves leading a team delivering rapid multidisciplinary assessment, treatment and supported discharge of frail older patients, especially those with complex combinations of medical, social and mental health problems.

Since his Consultant appointment, Tom has been seconded to work with commissioners on two occasions. In 2005, he reviewed best practice and made recommendations on the medical model of transitional care for Sheffield, resulting in the appointment of four community geriatricians bridging across acute and community care. In 2008, he recommended a radical redesign of Sheffield's whole Intermediate Care service.

Tom has a special interest in the integration of health and social care systems, including commissioning and leadership. Following his Quality Improvement Fellowship, Tom developed the role of Clinical Lead for QI at Sheffield Teaching Hospitals. The Service Improvement team in Sheffield offer a wide range of support and opened the Sheffield Microsystem Coaching Academy in 2012 to build improvement capability in the workforce.

The team have subsequently developed a mesosystem coaching programme 'Improving Flow' in which pairs of coaches facilitate staff from across a condition based pathway to improve the flow of care. The programme aims to spread by a replication model of social franchise opening Flow Coaching Academies supported by The Health Foundation.

Tom has facilitated the redesign of frailty care in Sheffield. He coaches staff in a Toyota Big Room to test and implement a multidisciplinary Frailty Unit and the novel flipped approach of ‘Discharge to Assess’. This has achieved 30% reduction in hospitalisation with lower mortality. He is currently coaching staff designing higher levels of more complex discharge aiming to optimise independence.

Tom is Deputy Editor of the Royal College of Physicians’ Future Healthcare Journal

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