Professor Sharpe’s editorial summarises elegantly the latest developments in psychological medicine. ^{Reference Sharpe1} The economic evaluation of the liaison services that started with the evaluation of the Birmingham Raid Model has naturally progressed with the recent National Institute for Health Research Health Services and Delivery Research Programme on commissioning research grants for ‘Organisation, quality and cost-effectiveness of psychiatric liaison services in acute settings’. This call was also accompanied by another one on ‘Assessing alternatives to face-to-face contact with patients’. The outcomes of these two calls will undoubtedly bring a new wave of changes to our current liaison services that are already undergoing remodelling. The editorial argues that ‘small’ liaison subspecialties should ‘join forces under a single banner’ to provide ‘flexible and shared service provision’. Liaison Services for Older Adults (LSOA) are among those that are numbered in the list of small subspecialties. Our analysis of the LSOA within our locality ^{Reference Mukaetova-Ladinska, Cosker, Coppock, Henderson, All-Ashgar and Hill2} and wider ^{Reference Mukaetova-Ladinska3} confirms that the LSOAs appear to be the fastest growing liaison discipline. In Newcastle alone we witness a steady 10% yearly increase of older people referred to our service, with the overall numbers being very close to those of our Deliberate Self Harm (DSH) team (37% LSOA v. 39% DSH). ^{Reference Mukaetova-Ladinska3} Those of us who already work in the newly integrated liaison services are under increasing pressure to become more generalist, shadow our DSH colleagues to ‘broaden’ our clinical experiences, while at the same time the suitability of referrals to our ‘small’ subspecialty is frequently scrutinised. And yet, the majority of hospital beds are occupied by older people who are physically compromised and cognitively impaired, who are either known to old age psychiatry services or are referred to the LSOA as a result of the Dementia Commissioning for Quality and Innovation (CQUIN). For many of them, our subspecialty would facilitate the diagnosis and initiate the treatment for their cognitive impairment, challenging behaviour and/or depression, and our expertise would aid the decision about their long-term needs and placement and enable/maintain that essential continuity of care that is currently failing them. ^{Reference Cornwell, Levenson, Sonola and Poteliakhoff4,Reference Cornwell5} In addition, the LSOA medical expertise is not confined to our old age psychiatric knowledge, but many of us are also dual trained (e.g. family medicine, neurology) and/or hold diplomas in geriatric medicine. The threat of ‘small’ subspecialties being assimilated by the generalist type of liaison services is a reality. However, the question remains - is this the best way forward? Mental health trusts have already benefited from a number of diversifications of services. ^{Reference Lintern6} The rapidly changing demographics in the UK population - with the older population doubling by 2050 from 10 to 19 millions ^{Reference Cracknell7} and the expected 80% increase in people with moderate or severe dementia in the following 15 years ⁸ - argues for urgent diversification of the health services to meet older people’s health requirements, including their mental health. In this respect, it would be counterproductive to rely on liaison services catering for a single commodity. The steady growth of LSOA demand provides further support that this is the area for diversification of not only the psychology medicine portfolio, but also mental health services in general.