TREAT HOT Clinic: Royal Free Hospital

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The Triage and Rapid Elderly Assessment Team (TREAT) at the Royal Free assesses older patients' needs quickly, including a specialist elderly medical component, within a multidisciplinary structure.

TREAT includes consultant geriatricians, registrars, frailty advanced clinical practitioners, physiotherapists, occupational therapists, clinical nurse specialists and pharmacists. 

The aim of our service is to provide a rapid access, one-stop assessment and diagnostics to avoid an unplanned presentation of older patients to ED. We also work closely with our community teams to ensure patients receive the appropriate support and monitoring at home.

HOT clinic is a one-stop clinic that is part of TREAT and runs five days a week at the Royal Free on the lower ground floor next to the Emergency department. 

Please note, patients must have been seen and examined by the referring doctor. The referring GP is responsible for patient transport to the hospital.

Eligibility criteria


  • patients that are >80 years with complex needs who require quick, comprehensive, geriatric assessment and intervention; should be patients who are expected to need admission within 48–72 hours, if no intervention were provided
  • patients with exacerbation of chronic conditions who require rapid investigation and treatment
  • specific conditions
    • patients with high risk of further falls or syncope
    • off baseline mobility
    • infections unresponsive to oral antibiotics who could remain at home during intravenous treatment
    • patients under PACE/RAPID who require medical review or practical procedures.


Patients who:

  • are clinically unstable (low BP, tachycardia, low saturation)
  • are drowsy or have reduced GCS
  • have diarrhoea 
  • have a suspected stroke or TIA
  • require hoist for transfer
  • have trauma/falls with suspected major injury
  • have a head injury
  • have severe delirium
  • have chest pain.

How to refer

ALL referrals must be discussed with the TREAT consultant and then an email of the referral should be sent to

Provided By

Service Feedback

General Services

Adult Safeguarding

Child Safeguarding

Community Services

Navigating Self-Care

Urgent & Emergency Care for Adults

Urgent & Emergency Care for Children

Review date: Thursday, 02 November 2023