Working as an Extensivist GP

Dr Margaret Lupton is a GP in North West England with over 20 years’ experience in General Practice. She joined the Blackpool, Fylde and Wyre Extensive Care Team in January 2016. She is one of the key speakers at the BGS Autumn Meeting during the Community Geriatrics Afternoon on Wednesday 23 November. She tweets as @magsielodge

maggieI have been a GP for 20 years and over this time I have witnessed the patient population becoming gradually older with increasingly complex problems. Also, GPs have become more and more involved in their patients’ chronic disease management. The standard 10 minute GP appointment just isn’t long enough anymore to deal with these older patients who have complex needs. For a long time I have been interested in exploring new ways of working and new models of care and so when I got the chance to join the Blackpool, Fylde & Wyre Extensive Care Service, I jumped at the chance. Continue reading

Book Review: Problem Solving in Older Cancer Patients

Dr Shane O’Hanlon is a consultant geriatrician with a special interest in surgical liaison and cancer care for older people. He tweets @drohanlon

book reviewAs geriatricians seem ever thinly spread, the possibility of us providing input to the population of older people with cancer seems challenging – especially when you consider that a majority of cancer diagnoses and deaths occur in the over 65s. However oncogeriatrics has taken root in the past 2 or 3 years and there are now a few centres nationally offering just this approach. For those geriatricians who are hoping to provide it (or oncologists who are trying to entice them) this book will be of great interest.

“Problem solving in older cancer patients” is published in association with the Association of Cancer Physicians (ACP), and also the British Geriatrics Society (BGS) (but this of course does not affect the objectivity of this review!). It represents a great team effort by a range of geriatricians and oncologists, including trainees. Continue reading

Sleep outs – nemesis of every clinician

Adhi (V Adhiyaman), geriatrician and Chair of Welsh council of the BGS. Tweets at @adhiyamanv

bedEvery clinician hates having sleep outs. Sleep outs or outliers used to be a rare occurrence in the past and happened only in extremely busy winter months. Now it is a norm due to reduction in bed capacity across England and Wales. In every hospital there are around 15-30 sleep outs at any time (even more if one includes the patients in emergency department waiting for a medical bed).

Most of the sleep outs are direct admission of medical patients to non-medical wards. It is not the clinicians who decide the sleep outs anymore. Bed managers make this decision and frequently hassle the medical registrars to identify sleep outs so that they don’t have to take the ownership of their decisions. Registrars are fed up of doing this as they are always busy with the take or dealing with other medical issues.    Continue reading

If you are one of the 1 million + patients the NHS deals with every 36 hours, wouldn’t you want a friendly face dedicated exclusively to your non-clinical needs?

Jullie Tran Graham is a Programme Manager in the Health Lab at Nesta. She has an interest in our (you, me, and the rest of society) collective ability to work alongside public services to make positive contributions to the way services are provided. She tweets at @tran_graham

integrated_care_pathway_-_age_ukVolunteering is a long-established tradition across the NHS. Millions of people already volunteer in health and care, but tens of millions would consider it. How do we tap into this resource most effectively and ensure that volunteering input is creating the most impact on patient experience and outcomes? The Helping in Hospitals programme looked to answer these questions and more. In 2013, Nesta, the UK’s innovation charity, launched the Helping in Hospitals programme, with funding from the Cabinet Office and the Department of Health. Over the past two years, we have worked with ten hospital trusts in England to support the creation of impact volunteering opportunities such as roles that improve dementia care and roles that facilitate better nutrition for older patients. We have also worked with our evaluation partners, The Social Innovation Partnership (TSIP), to systematically measure of the impact of these volunteering roles in hospitals through informal match comparison groups, where possible and pre-post approaches.    Continue reading

We need to talk about caring: dealing with difficult conversations

Anna Davies is Policy and Research Manager at Independent Age.

Difficult-conversations-cover_1As a charity supporting older people, we know that conversations about ageing and future care needs are often put off until times of crisis. In some ways this should come as no surprise – thinking about mortality and threats to independence stir up complex emotions for everyone. But we also know the impact of these missed conversations: in particular families struggling to make decisions around care or housing without being sure of their relatives’ wishes. And with more and more older people likely to be relying on family support in the future – one estimate suggests a 63% increase in the number of older disabled people receiving informal care by 2035 – this is not an issue that is going away. Continue reading

The Older Person’s Nurse Fellowship Conference 2016: Bridging the gap between research and practice through nurse-led quality improvement in older person’s services

Dr Corina Naughton, is a senior lecturer in the Florence Nightingale Faculty of Nursing and Midwifery, Kings College London. Corina is joint Lead for the Older Person’s Nurse Fellowship programme. She tweets at @corina_naughton

OPNThis was the first year of the Older Person’s Nurse Fellowship (OPNF) conference, hosted by the Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, in collaboration with Health Education England (HEE). The conference brought together leading older persons’ nurse research and front-line nurse-led quality improvement initiatives undertaken by senior clinical nurses from the OPNF programme. The conference was chaired By Baroness Sally Greengross and Sir Keith Person (Chair HEE). Continue reading

Which screening tool(s) should clinicians use for the detection of delirium in older, hospitalised patients?

Kirsty Hendry is a research assistant based at Glasgow Royal Infirmary having recently completed her PhD at the University of Glasgow. In this blog she discusses her recent Age and Ageing paper looking at screening of delirium in older, acute care in-patients. Kirsty can be contacted at

A&ADelirium, suggested to be the most common psychiatric disorder suffered by older hospitalised individuals, has a low clinical awareness. This is despite existing guidelines such as those produced by the National Institute for Health and Care Excellence (NICE) and Healthcare Improvement Scotland (HIS) being in general agreement that delirium screening is important in older hospitalised patients.  Continue reading

‘Beloved old age and what to do about it’ A review for Julia Jones

Liz Charalambous is a qualified nurse on a female, acute medical HCOP (Health Care for Older People) ward at Queen’s Medical Centre, Nottingham University Hospital Trust. She tweets at @lizcharalambou and is a regular guest blogger for the BGS.

Margery Allingham

Julia JonesBeloved old age is a fitting tribute to Margery Allingham, author of detective fiction (including most notably that of Albert Campion, later converted to a TV series). Published on the 50th anniversary of Allingham’s death, and illustrated with black and white photographs from both eras, the book is a work of two parts. It contains the accounts of caring for older relatives, seamlessly interposed between each era to span over half a century. Allingham’s previously unpublished work, ‘The Relay’, describes her experiences of caring for three elderly relatives more than fifty years ago. The account is brought to life by Julia Jones as she picks up the baton and continues the story with her experiences of being a carer for her mother with dementia, to present the story of ‘Beloved old age and what to do about it’. Continue reading

What is an STP? Do you know what is in your area’s Sustainability and Transformation Plan?

Caroline Cooke is BGS’s new Policy Manager. She joined us at the beginning of June. Here she explains the significance of STPs for health and care services in England.  

carolineThe constant change and the number of new initiatives in the NHS can be bewildering if you haven’t been directly involved at the start.  Or if you have been involved you may be experiencing a mixture of excitement, frustration or cautious optimism at the prospect of new ways of working that are ultimately aimed at delivering fully integrated health and care services. Staying up to date and engaged with the plans that NHS England is driving forward is key if you want to have an influence on them. Continue reading

If it’s everyone’s business, lets make a plan

Pamela Levack is Medical Director of the charity PATCH – Palliation And The Caring Hospital

patchDavid Oliver’s recent blog in the BMJ End of Life Care in hospital is everyone’s business, reports on the findings of the recent Royal College of Physicians Audit into End of Life Care. The two main findings, a need to increase the number of specialist palliative care doctors and specialist palliative care nurses in hospital and to ensure that newly qualified doctors have more knowledge and confidence dealing with end of life situations, match the aims of our recently established charity PATCH Palliation And The Caring Hospital Continue reading