The British Geriatrics Society calls for all healthcare professionals to learn from the Gosport Inquiry to help prevent future tragedies

The British Geriatrics Society is calling all healthcare professionals to review the Gosport Independent Panel Report, and to learn from these shocking events which led to the deaths of over 450 patients who were given opiate painkillers “without medical justification” from 1989 to 2000 at Gosport War Memorial Hospital in Hampshire.

The Inquiry found there was a “disregard for human life” and an “institutionalised practice of shortening lives” at the hospital. In response to the Inquiry’s findings the Society is also calling for increased knowledge of best practice and clinical guidelines, especially in relation to prescribing and pain management in older people. The Society fully supports the families’ ongoing quest for truth and accountability.

The British Geriatrics Society welcomes £20 million investment to help tackle loneliness

The British Geriatrics Society welcomes yesterday’s joint statement by the Prime Minister’s Office and the Department for Digital, Culture, Media & Sport announcing that charities and community groups will get £20 million of new funding to help people experiencing social isolation and loneliness.

Healthcare professionals now recognise loneliness as a ‘public health epidemic’ with evidence to suggest it is as bad for health outcomes as smoking 15 cigarettes a day[i]. Older people are one of the groups most at risk. In the UK, over 1 million older adults admit they feel lonely often or all the time[ii], a number set to increase given the changing demography.

Is frailty becoming less fatal?

Professor Fiona Matthews is Professor of Epidemiology at Newcastle University, Newcastle-upon-Tyne, UK. In this blog, she shares a recent Age and Ageing publication looking at data collected since the 1990s on how much frailty exists in the population and whether it is more or less related to dying now than 30 years ago.

Most doctors involved in the care of older people would claim to know a frail patient when they see one. Being able to detect this frailty is crucial to ensure that treatment is appropriate, proportionate and likely to produce positive outcomes wherever possible. The measurement of frailty has become important recently with the inclusion of frailty within the requirements of an assessment in general practice, and tools to assist doctors in emergency departments evaluate frailty quickly. The most popular method for these investigations has been the frailty index, where diseases and impairments are added all together to give a score. The relationship between this frailty index and mortality has been seen across the world, giving rise to suggestions that it is one measure that is consistent across time and place.

‘How low to go?’ Top transatlantic research journals debate antihypertensive treatment in older people

The scientific journal of the British Geriatrics Society, Age and Ageing, and the Journal of the American Geriatrics Society have launched a joint initiative, publishing two articles debating the relative benefits and risks of treating hypertension in older people.

It is widely recognised that raised blood pressure is probably the single most important treatable risk factor for cardiovascular disease in later life. The evidence that older people can benefit from antihypertensive drugs has accumulated with a succession of randomised controlled trials over the past 35 years. These trials have shown reduced risk of stroke and myocardial infarction, as well as decreased total mortality. However, despite the extensive evidence that is now available, questions remain about who to treat and on optimal blood pressure targets. Consequently practice varies widely and many clinicians are uncertain about what best to recommend for their older patients.

Palliative care provisions are not meeting the needs of an ageing population

A commentary published today in Age and Ageing, the scientific journal of the British Geriatrics Society, warns despite the fact that frail older people with multiple illnesses and end stage dementia are the most rapidly growing group in need of palliative care current provisions are not aligned to meet their needs.

The authors of the commentary noted that current projections indicate that between 25% and 47% more people may need palliative care by 2040 in England and Wales. A high proportion of these people will die following a prolonged period of increasing frailty and co-morbidity including cancer, but also other long-term conditions such as heart failure, chronic obstructive pulmonary disease, diabetes or renal failure.

BGS Rising Star Awards: Ruth Law and Thomas Jackson

The BGS Annual Rising Star Award recognises young doctors, nurses and AHPs who have made exceptional contributions to the field of older people’s health care, early in their career. Two awards are available each year; one for research contributions that have translated into, or are in the process of being translated into, improvements to the care of older people, and the other, for a clinical quality project which improves the care of older people with frailty in the award holder’s locality.

In 2017, the award for quality went to Dr Ruth Law, Consultant in Integrated Geriatric Medicine, Whittington Health, for her work with the Integrated Community Ageing Team (ICAT) in Islington and to Dr Thomas Jackson for the work he has been doing in research.

Ruth trained mainly in and around London. She says that her training included a formative year as part of the stroke team at the National Hospital for Neurology and Neurosciences where she had the privilege of working alongside world-class researchers as they developed a new service.

The British Geriatrics Society calls for urgent action on hunger and malnutrition among older people

The British Geriatrics Society welcomes the recently published report by the All Party Parliamentary Group (APPG) on Hunger. The report highlights that malnutrition is most likely to arise among older people following an accumulation of setbacks – for example bereavement, illness, a loss of community transport services, and a nearby shop closing,  – which leave them unable to access food easily.

Geriatric medicine has always recognised the importance of nutrition and sufficient intake of food and fluid in patient care. We hope that as a matter of urgency Government will seek to address the recommendations from the APPG so that malnutrition in older people, and those at risk of malnutrition, is identified and treated as quickly as possible.

Specialist Care Frailty Network – we need your help!

Dr Simon Conroy is a geriatrician at University Hospitals of Leicester, Honorary Senior Lecturer, University of Leicester and an Associate Editor for Age and Ageing journal. 

Dear fellow BGS members,

Some of you might have heard about the Acute Frailty Network, which has been in existence for a few years now. The focus of the Acute Frailty Network has been acute medical care and to some extent emergency care. The Specialist Care Frailty Network will focus upon the care of older people with frailty in six specialist services:

• Renal Dialysis
• Chemotherapy
• Emergency Cranial Neurosurgery
• Interventional Cardiology
• Complex Spinal Surgery
• Adult Critical Care

Number of older people with four or more diseases will double by 2035, say researchers

A study published recently in Age and Ageing, the scientific journal of the British Geriatrics Society, reports that the number of older people diagnosed with four or more diseases will double between 2015 and 2035. A third of these people will be diagnosed with dementia, depression or a cognitive impairment.

The study, conducted by researchers at Newcastle University’s Institute for Ageing, found that over the next 20 years there will be a massive expansion in the number of people suffering from multiple diseases, known as multi-morbidity. As a result two-thirds of the life expectancy gains, predicted as 3.6 years for men, 2.9 years for women, will be spent with four or more diseases.

1Ib beefsteak, with 1 pt bitter beer every six hours…

Pandora Wright is a Consultant in Elderly Medicine, Charing Cross Hospital, Imperial Healthcare NHS Trust. 

 “1Ib beefsteak, with 1 pt bitter beer every six hours. 1 ten-mile walk every morning. 1 bed at 11 sharp every night. And don’t stuff your head with things you don’t understand.”  (Jerome K Jerome. Three men in a boat)

With no NICE or SIGN guideline on the management of anaemia and iron deficiency in older people, we determine our own management plans and pathways.

Anaemia is common in older people, accounting for  10% of over 65’s, rising to up to 30% of over 85 year olds. Its presence in this age group is associated with frailty, falls and significantly impacts on survival, quality of life and hospital admission and readmission rates.