Lloyd & Mayou (Reference Lloyd and Mayou2003) argue cogently for the development of liaison psychiatry, or ‘psychological medicine in general hospitals’ as they prefer it. Their arguments would carry more weight with commissioners if they included the mental health needs of older people. Two-thirds of general hospital beds are occupied by people aged over 65 and it is obvious to anyone visiting a general medical ward that the majority of ‘bed-blocking’ is caused by older people with dementia, depression and prolonged delirium. The epidemiology, together with demonstrably poor coordination of services, is highlighted in a recent report, partly commissioned by the Faculty of Old Age Psychiatry of the Royal College of Psychiatrists (Reference Holmes, Bentley and CameronHolmes et al, 2002).

The time is now ripe for old age psychiatrists to take their multi-disciplinary skills and experience of community support into general hospitals to enable earlier discharge of so-called bed blockers. Liaison psychiatrists could develop their services (and sub-speciality status) more quickly and comprehensively if they worked more closely with old age psychiatry colleagues clinically, and within the Royal College of Psychiatrists.