Person-centred care in a sustainable system

Dr Eileen Burns has been a geriatrician in Leeds since 1992 and is President of the BGS. She is currently Clinical Lead for integration in Leeds. She tweets @EileenBurns13 This blog originally appeared as part of Independent Age’s Doing Care Differently series. You can join the debate here.

We warmly welcome Independent Age’s new project, Doing care differently. Our members are passionate advocates for person-centred care. The role of geriatricians and specialist health care professionals starts with identifying the care and treatment that best suits an older person’s individual needs and wishes, and those of their families and carers.  Delays in access to social care, and also in intermediate care, for example, occupational and physio therapy, create unnecessary barriers to person centred care, leading to poorer health outcomes, an increased likelihood of presenting at A&E, and people having to stay on acute hospital wards for longer than necessary.  For older people with frailty the negative impact when this occurs is significant, and their health deteriorates with every additional day spent on an acute hospital ward.

Autumn Speakers Series: Is it just me… or have we listened and changed?

Sharon Blackburn has worked in the independent care sector for over 28 years, having previously spent 10 years in the NHS in a variety of roles. Sharon is currently Policy and Communications Director for the National Care Forum. She was awarded an CBE in the 2016 New Year’s Honours for services to nursing and the not-for-profit care sector. She tweets at @NCFSharon She will be speaking at the upcoming BGS Autumn Meeting in London.

Care Homes routinely feature in the press and not always for the right reasons. Sadly the negative experiences and stories do little to help us all promote the amazing work that is being done with people who live in care homes up and down the country. Instead it feeds peoples’ already distorted views and understanding, including those of professionals. Andrea Sutcliffe, Chief Inspector for adult social care at the Care Quality Commission (CQC) talks about the ‘mum’ test – “would this service be good enough for my mum?” I would suggest the ‘mum’ test needs to be more up close and personal… “would this service be acceptable to me”?

The Challenges of Research in the Care Home Setting

Annabelle Long is a Chartered Physiotherapist working as a Research Assistant at the University of Nottingham on a Dunhill Medical Trust funded PEACH study, which considers the role of Comprehensive Geriatric Assessment in UK care homes. She has a developing research interest in wellbeing for people with dementia in community environments. In this blog she outlines the potential challenges and solutions in doing research at the health and social care interface.

As practitioners and researchers in care of older people, it is important for us to be continually working to include more dependent groups in research. The reason for doing so is to ensure that the evidence base can reliably be applied to the patients we see in everyday practice. However involving older people with dependency in research can be challenging because cognitive and physical impairments can make standard procedures for recruitment and data collection difficult.

Every older person in a care home needs access to high quality healthcare

The British Geriatrics Society (BGS) calls for everyone who commissions or provides healthcare in care homes to follow the principles of good practice set out in the guidance we are publishing today, so that every older person who lives in a care home in the UK has access to high quality healthcare which fully meets their needs. Based on the clinical expertise of our members our updated guidance sets out clinical and service priorities for how best practice can be achieved, and provides clear indicators of what successful delivery looks like for older people, their families and carers.

In the UK 405,000 people over the age of 65 years old currently live in care homes. This represents 16% of older people over the age of 85. Their healthcare needs are complex and the average care home resident has multiple long-term conditions, and frailty. They are likely to have better health outcomes if health services reflect these needs, and they have access to comprehensive, multidisciplinary assessment, with input from healthcare specialists trained in the care of complex medical problems in later life.

Multi-morbidity – the case for change

David Paynton is a GP in an inner city surgery. He is also the Clinical Lead for Commissioning for the RCGP.

Generalists are the solution.

For too long policy makers have ignored what clinicians on the front line have been telling them, people with multiple conditions not only exist but are the mainstream.

It is our failure to recognise this fact that has put pressure in the system as the NHS struggles to keep its head above water especially when one adds social factors, depression and mental health into the mix of complexity.

The RCGP “responding to the needs of patient with multi-morbidity” has created a powerful case for change with the need to substitute ever-increasing investment into super specialism by a call for the generalist to support those with multi-morbidity in the community.

Take the high road or the low road…but don’t miss the BGS in Glasgow this November!

Dr Eileen Burns has been a geriatrician in Leeds since 1992 and is President-Elect of the BGS. She is currently Clinical Lead for integration in Leeds and Chairman of the BGS Community Geriatrics Special Interest Group. She tweets @EileenBurns13

The Autumn Meeting of the BGS in Glasgow this November looks to be a great event with a broad range of topics and sessions.

But the day that excites me the most is Wednesday November 23rd.

Many of us have been approached by commissioners of services to “move into the community” in some way (in whichever part of the UK we are based). Others have seen the need to look at alternatives to acute hospital care for older patients with less severe illnesses, and it’s been clinicians rather than commissioners or managers who have been the spark for new developments.

Underfunded. Underdoctored. Overstretched.

Dr Zoe Wyrko is a Consultant physician at University Hospital Birmingham and is the Director of Workforce for the BGS. In this blog she discusses the recent RCP report ‘Underfunded. Underdoctored. Overstretched. The NHS in 2016‘. She tweets @geri_baby

The Royal College of Physicians have published a report Underfunded. Underdoctored. Overstretched. The NHS in 2016. It clearly lays out that honest debate is needed, and choices are going to have to be made – increases in funding or cuts in care. It states that a new plan is needed, not yet another  quick fix or temporary solution, rather one that is designed to meet the UK’s health and care needs in the long term, and that values, supports and motivates NHS staff.

Making it happen! An Acute Clinical Team in action

Firdaus Adenwalla is a consultant geriatrician in ABM University Health Board.  He is part of the Neath Port Talbot Acute Clinical Team providing an intermediate care service for the community. 

The media reminds us daily of how our health service is not keeping pace with our changing world. The negativity around health care, hospitals overflowing, not enough doctors, not enough nurses, GP practices closing, and the list goes on. Increasing demand, improved technology and our increased life expectancy, all compound the notion that our health service cannot meet our needs.

Integrated care – how to make a mountain out of a molehill?

David Stott is Professor of Geriatric Medicine at the Institute of Cardiovascular and Medical Sciences at the University of Glasgow and is Editor in Chief for Age and Ageing journal.

Integrated health and social care has been promoted as a key solution to the challenge of providing high quality care with a restricted budget. Philp summarises current thinking in a New Horizons article recently published in Age and Ageing.

The aim of providing a fully integrated system including coordination of organisation of health and social services sounds sensible. After all who would argue for disintegrated and disorganised care?

However there are problems and challenges, not with the concept of integration, but in the organisation and systems that are being ‘pushed’ to effect integration.

The NHS England Five Year Forward View: A crucial document for our speciality, for the care of older people and for Health and Care Services in England.

David Oliver is President of the BGS, Visiting Fellow at the King’s Fund and Consultant Geriatrician at the Royal Berkshire Hospital, Reading. In part 1 of a 2-part blog, he discusses how the NHS “Five Year Forward View” is important for people involved in the care of older people.

October 23^rd 2014 is memorable to me, as it’s my 23^rd wedding anniversary. It’s also now of significance to the rest of us, as the date that NHS England’s “Five Year Forward View” plan was published. I realise not many of you will have had the time or necessarily inclination to read it, though at only 39 pages it’s an easy canter.

I also know it hasn’t attracted much Twitter activity from fellow BGS members. But it’s a document which I suspect will have far reaching influence and implications for the services we all work in. These implications seem largely positive. Let me explain why.