In 2003 the Executive Committee of the Faculty of Old Age Psychiatry agreed to fund a working group to produce guidelines for the development of liaison mental health services for older people. In stark contrast to working age adults, no speciality of liaison psychiatry exists for older people.

Consequently, older people, who occupy two thirds of NHS beds, have no access to specialist liaison mental health services. Up to 60% of older people admitted to general hospitals will have, or will develop, a co-morbid mental disorder and this mental disorder will be an independent predictor of poor outcome. These poor outcomes include increased mortality and length of stay, loss of independence and increased transfer to institutional care.

One way in which outcomes can be improved for older people in general hospitals is through the development of specialist liaison mental health services for older people. These services can provide timely advice and assessment where required, together with education and training aimed at improving the knowledge, skills and attitudes of general hospital staff in the management of older people with mental health problems.

Who Cares Wins is the document produced by the working group and is endorsed by the British Geriatrics Society, Royal College of Nursing and the Alzheimer's Disease Society. It sets out the case of need, service development and the evidence that attending to mental health improves outcomes for patients and hospitals. It makes specific recommendations for acute trusts, mental health trusts and health and social care commissioners. It is essential reading for anyone involved in the commissioning and provision of general hospital services.

Who Cares Wins demands that ageism preventing older people receiving specialist services must be addressed and demonstrates why any strategy to improve the performance of general hospitals will be seriously deficient if it fails to attend to the mental health needs of older people.