Caroline Cooke is Policy Manager at British Geriatrics Society. Caroline is currently supporting a joint project being carried out by BGS and the Old Age Faculty at the Royal College of Psychiatry. Here she explains the aim of the project and how you can help to make it a success.
In the UK 405,000 older people (65+) currently live in care homes. Older people living in care homes have complex health needs and most residents have multiple long-term conditions, significant disability and frailty which affect both their physical and mental health. Dementia affects the majority of residents in care homes to some degree and depression is common. Integrated provision is required to meet the needs of care home residents who require co-ordinated input from generalists and specialists in multiple disciplines, and partnerships are essential to integration. Continue reading
Caroline Cooke is Policy Manager at BGS. Here she explains why BGS has published its own election manifesto, what it says and how you can get involved.
The 2017 General Election offers an opportunity to promote the issues that most affect the healthcare of older people across the UK. By publishing our own manifesto we are helping to raise awareness and understanding among key opinion-formers and decision-makers, including parliamentary candidates, of the work of BGS and the unique expertise of our members. It is also a way of demonstrating that BGS will be working to influence policy development after the election. Continue reading
Caroline Cooke is Policy Manager at BGS and Premila Fade is BGS’s End of Life Care Lead. Here they explain the background to, and significance of, the report published by the Law Commission, “Mental Capacity and Deprivation of Liberty” on 17 March 2017.
What are DoLS? The Deprivation of Liberty Safeguards (DoLS) are a set of protections for adults who lack the mental capacity to consent to deprivation of their liberty by, for example, admission either to hospital or a care home for treatment or care. They were introduced as part of the Mental Health Act 2007. The intention behind their introduction was to ensure that no-one is deprived of liberty without good reason, and the right of legal challenge is built into the authorisation process. The idea was to close the so called ‘Bournewood gap’ whereby adults admitted informally (i.e. not via the Mental Health Act) did not have an automatic right to appeal. The European Court of Human Rights (HL v United Kingdom) ruled that this lack of safeguards was a breach of article 5 ‘The right to Liberty’ of the Human Rights Act. Continue reading
Dr Olivier Gaillemin trained in Geriatric Medicine and now works as a consultant physician in Acute Medicine at Salford Royal Foundation Trust. He has developed a Frailty Unit embedded within the Acute Medical Unit. He sat on the NICE guideline development group for NG27 – Transitions of care for adults with Health and Social Care needs – as well as on the committee for the associated NICE Quality Standard QS 136. He attended the King’s Fund conference as a speaker.
On the day of the launch of their report on STPs, the King’s Fund hosted an event on how to improve transitions of care for older people admitted and being discharged from hospital. In these times of very real stress to the systems in which we work, when too often we seem to fail those vulnerable people we are all invested and motivated in supporting, it is easy to become despondent. Continue reading
Shelagh O’Riordan is a consultant geriatrician and the clinical lead for the National Audit of Inpatient Falls. She was an acute hospital geriatrician in Canterbury in Kent for 14 years but moved in September 2016 to work Kent Community Foundation Trust as a community geriatrician. She developed and runs East Kent Falls and Osteoporosis service. She tweets at
As the clinical lead for the National Audit of Inpatient Falls (NAIF) I have been involved in the development of some new tools to standardise fall prevention in hospitals and they are being launched this month. The first of these was launched on 13/01/17 and is on the measurement of lying and standing blood pressure.
One of the results we found in the last audit round (data collected May 2015) was that on average only 16% of patients over 65y in an acute hospital after 48 hours had had a lying and standing BP recorded! I found this to be a fairly shockingly low number. I’m known, like many geriatricians, to be a bit obsessed with measuring lying and standing BP. Continue reading
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. Continue reading
Calling all BGS Members and friends! We are inviting you to complete this survey to help us find out more about what our members, and other visitors, are looking for from the new BGS website which will replace the current main BGS site.
This survey should take no longer than 5 – 10 minutes to complete, depending in the length of your answers. This survey also provides the opportunity to join the Website Consultation Group and/or volunteer to review and update existing materials from the current site. Continue reading
Across the UK, innovative collaborations between GPs and specialist geriatricians are paving the way to better care for older people with frailty
A new joint report from the Royal College of GPs and the British Geriatrics Society has been published today, showcasing how GPs and geriatricians are collaborating to design and lead innovative schemes to improve the provision of integrated care for older people with frailty.
Advancements in medicine are a great success story, and as a result our patients are living longer, but they are also increasingly living with multiple, long term conditions and that brings a number of challenges for general practice and the wider NHS.
Older patients make up the majority of those attending GP surgeries and acute hospitals so getting the right combinations of care in the right place and at the right time is crucial to avert avoidable admissions and delayed discharge from hospital. Continue reading
Prof Finbarr Martin is a Consultant Geriatrician at Guy’s and St Thomas’ NHS Foundation Trust and Professor of Medical Gerontology at King’s College London. He is a former President of the British Geriatrics Society.
How good is your department and hospital at preventing your patients falling? About 600 inpatients fall every day. As clinicians, we are fully aware of the injuries that can result from older people falling in hospital and the serious effect a fall can have on their recovery. So what can we do to prevent this happening? NICE guidance suggests we can reduce the number of falls by up to a third. The issue is high on the national patient safety agenda, but we need to be able to gather reliable data to ascertain if greater awareness is leading to the falls rate reducing.
Last year, the London Royal College of Physicians carried out an audit of hospital policies and practice in falls prevention, producing a national picture and a report on each hospital in England and Wales. The audit items were based on guidance from NICE and NPSA. You can access the national report here. Please find the time to take a look at your hospital’s data. Continue reading
Simon Thomas is an Honorary Fellow of the School of Pharmacy, Keele University and a Director at Prescribing Decision Support – a Keele University spin-out company that delivers knowledge-based e-media systems designed to support healthcare decision making. Most recently, Simon has worked with NICE and Boehringer Ingelheim Ltd on the development of an innovative anticoagulation therapy decision support tool that assists patients and doctors in shared decision-making. Simon can be contacted at firstname.lastname@example.org
Falls and fall-related injuries in older people is a high-risk, high-cost problem. Notwithstanding the considerable human impact – distress, pain, injury, loss of confidence, loss of independence and mortality – falls account for the largest number of emergency hospital admissions for older people in the UK and cost the NHS over £2 billion each year. Continue reading