The Budget was a missed opportunity to help frail older patients stranded in hospital

The President of the British Geriatrics Society commented that the budget ‘failed to address the critical issue of delayed transfers of care for older people by increasing funding for social care’ at the Society’s national conference.

At the BGS national conference on Wednesday (22 November), Dr Eileen Burns, President of the British Geriatrics Society, called for the Chancellor to provide interim funding for social care to help medically fit older patients stranded in hospital wards return to their homes.

Dr Burns commended the government on its additional 10 billion pound capital investment in the NHS and the recent announcement that a Green Paper identifying long term solutions to the social care crisis will be published in the summer of 2018. Despite these measures healthcare professionals remain concerned that the ongoing limitations on social care funding will continue to put intense pressure on the NHS. Continue reading

‘Geriatrics for Juniors’ is 5! Where, when and what next for AEME?

Dr Nick Saxton is an ST5 in Geriatric Medicine living and working in the North East of England. He attended the first ‘Geriatrics for Juniors’ conference as a core medical trainee in 2013. He began specialty training in 2015 and joined the Association for Elderly Medicine Education as treasurer in 2016. He tweets @saxton1986

Who are the AEME and what is G4J?

The Association for Elderly Medicine Education (AEME) is an organisation set up by trainee geriatricians in 2012, to provide educational tools and experiences in elderly medicine. The aim was also to attract more trainees into the specialty. You can follow us on Twitter and on Instagram @elderlymeded. AEME’s flagship event is our annual conference, ‘Geriatrics for Juniors’ (G4J), which is now in its fifth year. It’s a one-day conference aimed at foundation doctors, core medical and GP trainees and also specialist nurse practitioners who work with older patients. This year it is being held on 4th November 2017 at the Hilton Hotel Gateshead, Newcastle upon Tyne. Continue reading

Oncogeriatrics, gaining momentum!

Dr Kirsty Colquhoun has been a consultant geriatrician, working in Glasgow, since August 2015. She works across a variety of hospitals, including Glasgow Royal Infirmary, Gartnaval General hospital and The Beatson. In addition she works with Macmillan, developing oncogeriatric services. In this blog she discusses the BGS Oncogeriatrics Conference on 7 December 2017 at the Wellcome Collection in London. She tweets @colki1983

Oncogeriatrics…it is a relatively new speciality but those of us involved in it can see it is an exciting one, gaining momentum. The BGS Oncogeriatric SIG was inaugurated in 2015, and our annual meeting this year is on the 7 Dec 2017.

Particularly since the Cancer Services Coming of Age Report there has been increasing recognition that the way in which we manage our older patients with cancer, could, and should be improved and tailored to their specific needs. The benefits of CGA extend to cancer care, with outcomes and tolerance of treatment improving with its use. Continue reading

Autumn Speakers Series: Ageing and economic growth – not all doom and gloom?

Baroness Sally Greengross is Chief Executive of the International Longevity Centre – UK and has been a crossbench (independent) member of the House of Lords since 2000. She Co-Chairs four All-Party Parliamentary Groups: Dementia, Corporate Social Responsibility, Continence Care and Ageing and Older People. She was awarded a Special Lifetime Achievement Award at the BGS 70th Anniversary Reception on 6 March 2017.  She will be speaking at the upcoming BGS Autumn Meeting in London.

What are the economic and societal effects of a global ageing society and the increasing need for a healthy older population who will be employed into their 70s? 

Firstly it is worth saying that ageing and economic growth – is not all doom and gloom? Population ageing is a global phenomenon. The rate of growth in older people (people aged over 65) is expected to far outpace the rise of the working age population (people age 15-64). The old age population will grow by more than 300% over the course of this century by comparison with the working age population which will grow by less than 50%. Continue reading

Autumn Speaker Series: Exercise during periods of decompensation. What is the current evidence?

Stephen Lim is a Clinical Research Fellow and a Specialist Registrar in Geriatric Medicine in Academic Geriatric Medicine at the University of Southampton. His research interest is in physical activity and deconditioning in hospital. He will be speaking at the upcoming BGS Autumn Meeting in London. He tweets at @StephenERLim

Hospital-associated deconditioning is high on the agenda across hospitals in the UK and many hospital trusts have jumped on the ‘endPJparalysis’ bandwagon to encourage patients to get up and get moving, – and rightly so! It is encouraging to see that healthcare professionals and non-clinical staff members are increasingly aware that prolonged bedrest and immobility is bad medicine.

During an acute illness, older people are at risk of worsening sarcopenia and consequently a decline in physical function. The hospital environment, altered mental state, physiological stresses and poor nutrition (as a sequelae of the acute illness), are some of the important risk factors contributing to a loss of function. Continue reading

Autumn Speakers Series: Under what circumstances, and in what ways, is a quality improvement collaborative likely to succeed in a care home setting?

Dr Reena Devi is a research fellow in the Division of Medical Sciences and Graduate Entry Medicine at the University of Nottingham. She is working on the PEACH (‘ProactivE heAlthcare for older people living in Care Homes) study, which is led by Dr Adam Gordon, and funded by the Dunhill Medical Trust. She will be speaking at the upcoming BGS Autumn Meeting in London. She tweets @_DrReenaDevi 

Improving healthcare services delivered to older people is high on the national agenda. Nationwide initiatives are currently focusing on this, for example, six of the Vanguard projects set up in response to the 5 year forward view are specifically devoted to delivering new models of healthcare into care homes. Smaller scale initiatives are also being carried out in local settings, such as the PEACH project.

The PEACH project is using improvement science to bridge the gap between what we know and what we do in terms of the healthcare services delivered to care homes in South Nottinghamshire. The project is working with 4 clinical commissioning groups and their associated healthcare and care home providers, and is focusing on bringing healthcare services closer in-line with the Comprehensive Geriatric Assessment (CGA) model of care. Continue reading

Why the BGS Fringe?

Muna Al Jawad is a Consultant Geriatrician at Royal Sussex County Hospital in Brighton. Here she discusses the BGS Fringe which will be taking place at the BGS Autumn Meeting in London on 23 November. She tweets @OPWhisperer

The idea for the BGS Fringe comes from an emotion: Frustration, and a cause: Resistance. Frustration first. I realise this might be heresy (especially on a blog for the BGS) but the national conference really frustrates me. Geriatricians are the funniest, quirkiest and most humble of doctors. Lots of us chose geriatrics because we want to work with geriatricians. Of all the hospital specialists, we pride ourselves on being the most holistic, we see aim to see our patients as human beings, within their network of family and carers. “Aha!” the geriatrician will say on a ward round, “I know Mrs Jones, she loves Elvis and has a watch with a cat on it” (I actually said that last week).
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The frailty journey so far: where are we heading?

Professor Martin Vernon qualified in 1988 in Manchester. Following training in the North West he moved to East London to train in Geriatric Medicine where he also acquired an MA in Medical Ethics and Law from King’s College. In 2016 Martin was appointed National Clinical Director for Older People and Person Centred Integrated Care at NHS England. Here he discusses the 3rd National Frailty Conference which will be held on 28 September 2017 in Leeds. He tweets @runnermandoc 

The 19th Century term ‘watershed’ refers to a ridge of high ground separating bodies of water flowing in different directions. With this in mind I believe the 3rd National Frailty Conference in Leeds this year truly does mark a watershed moment. It will provide a valuable and timely opportunity both to reflect and add clarity to the new direction of travel we are taking with routine frailty identification and intervention for older people on a national scale. Make no mistake: bringing frailty into the mainstream is game changing.

Over the last year I have been continually impressed by the enthusiasm, ingenuity and commitment around the country focused on improving care and outcomes for our expanding and ageing population.  As a health and care system collectively we have much to celebrate from the hard work already done. Continue reading

Half the people in the world with Parkinson’s Disease have probably not been diagnosed – yet…

Richard Walker is a Consultant Geriatrician at North Tyneside General Hospital, and Honorary Professor of Ageing and International Health at Newcastle University. He has a research interest in non-communicable diseases in sub-Saharan Africa (SSA) and is Associate International Director for SSA for the Royal College of Physicians, London. He is the Clinical Lead for the Northumbria / Kilimanjaro Christian Medical Centre health link and Chair of the Movement Disorders Society African Task Force. In this blog article he discusses the growing challenge of Parkinson’s Disease in SSA.

I’ve recently got back from the 21st International Congress of Parkinson’s Disease (PD) and Movement Disorders in Vancouver where I chaired the African Task Force meeting. At the congress it was exciting to hear about all the new developments in the field, but it was perhaps unsurprising that there was very little research about the treatment of PD in lower and middle income countries (LMICs). Continue reading

Autumn Speakers Series: What is geriatric rehabilitation? Towards a unifying concept

Romke van Balen is an Elderly Care Physician in Rotterdam and Senior Researcher in Leiden. His main field of interest is geriatric rehabilitation. He will be speaking at the upcoming BGS Autumn Meeting in London.

Although geriatric rehabilitation in most countries is considered to belong to the core tasks of geriatricians, there is no consensus about definition and target groups of patients.

Decades ago, the Boston Working Group defined geriatric rehabilitation as a multidisciplinary set of evaluative, diagnostic and therapeutic interventions whose purpose it is to restore functional ability or enhance residual functional capacity in elderly people with disabling impairments. When looking at this definition, one wonders if it separates geriatric rehabilitation from the general aim of geriatric medicine. Only palliative care clearly has another aim. Continue reading