The future of hospitals is age-attuned

Prof Paul Knight is President of the BGS and is Director of Medical Education and Consultant Physician at the Royal Infirmary, Glasgow.

The Future Hospital Commission (FHC) has published its report and recommendations for ensuring that hospitals are designed around the needs of patients. The report recognises that older, frail and more complex patients with multiple long term conditions are the main patient group cared for in modern hospitals. It is critical that we meet the needs of these vulnerable individuals.

The FHC places welcome emphasis on the importance of Comprehensive Geriatric Assessment (CGA) but at the same time there are significant workforce implications for the expanded use of CGA in general hospitals.

The current health care workforce needs more training in geriatric medicine and hospitals must be age-attuned in terms of their physical environments and the skills and cultural attitudes of all staff working within them.  Doctors, nurses and allied health professionals need the right skills and values to provide compassionate and effective care for older patients.

The evidence shows that when frail older people are admitted to hospital, they are 25% more likely to be alive and living independently at home when they are looked after in a specialist unit for older people.  However, geriatric medicine departments are already stretched, as the beneficial impact of geriatricians’ specialist medical skills in hospital and community healthcare are recognised.  We support the move towards a seven day a week service but more geriatricians, with their associated teams of qualified nurses, therapists and social workers, are needed to ensure a high standard of specialist care for older, complex patients.

Over the course of this week, we’ll be conducting a detailed analysis of the impact of the FHC report for care of frail older people within the UK.  Each day we’ll focus on a different issue, with expert commentary on the implications for future practice.