Commissioning hip fracture care – the NICE way

Dr Karthik Kayan is onsultant orthogeriatrician at Stockport NHS Foundation NHS Trust.

Prof Opinder Sahota is consultant in elderly medicine at Nottingham University Hospitals NHS Trust and Joint Chairman of the Falls and Bones SIG at the BGS.mobility

It is well known in geriatric medicine circles that hip fractures are the most common osteoporotic fracture affecting predominantly older people.

Currently, the incidence of hip fracture emergency admission is around 70,000 in the UK and will continue to increase as the population ages. The projected incidence for hip fracture in the UK is 101,000 by 2020. The crippling effects of hip fracture are significant for the patient as independence is affected and a number of them die within a year of sustaining a fracture. The cost of managing osteoporotic fractures is £1.7 billion and over 90 per cent of this is due to health and social care costs associated with the fracture. Continue reading

Should we invest in newer forms of telecare?

Mr Adam Steventon is Senior Research Analyst Nuffield Trust.

As David Oliver’s recent blog mentions, there’s much interest at present in the potential of telecare to help frail older people maintain their independence at home. Telecare can take many forms. Since the Department of Health’s Building Telecare in England report, the number of pendant alarms in England has increased to around 1.5 million. Some local authorities are now beginning to invest in newer forms of telecare like automatic falls and bed occupancy sensors.

Advocates have claimed that telecare can deliver benefits for older people and their carers while reducing costs – the latter happening through reduced admissions to care homes and hospitals, and shortened of length of stay in hospital by virtue of faster discharge with the safety assurances that come from telecare. However, evidence about the effect of telecare on use of care services has been scarce, with several systematic reviews commenting on a paucity of high-quality research. Continue reading

NHS Consultants’ Association against commercialisation and fragmentation of the NHS

Prof Finbarr Martin is the past President of the British Geriatrics Society, a Consultant Geriatrician at Guys and St Thomas’ NHS Foundation Trust and Professor of Medical Gerontology (Hon), King’s College London

I must be one of many geriatricians increasingly concerned about the implications of the current health service changes on the services we can provide for older patients. Our aspiration is to provide reliable local quality services, with some semblance of integration – or at least coordination – between acute and community, and primary and secondary care.

Several areas in the country have made great strides in this direction and British Geriatrics Society members have been influential in the process. However progress is threatened by the government’s continued drive to competitive, piecemeal and price-based commissioning. Professional societies such as ours spoke against the Health and Social Care bill becoming law, but to no avail. The BMA has gone quiet.

Continue reading

January Newsletter out now

The January 2013 issue of the BGS newsletter is out now.  Visit the online archive of newsletters here.

Highlights of this issue are: geriatric medicine in the modern NHS, news for trainees, autism and ageing, memory rehabilitation, orthogeriatrics, end of life care and the Government’s mandate to the NHS Commissioning Board.NL-01-13

Full contents list:

Geriatricians’ Corner:- Ortho-geriatrics…..A tale of two specialities

Much akin to Charles Dickens’ famous tale of two cities, the orthopaedic bastille has been stormed with the publications of the Blue book and BOAST 1 guidelines. Supported by heavy artillery in the form of the new HRG tariff for hip fractures, the revolution has well and truly begun. Ortho-geriatric services across UK have been transformed and this has catapulted this emerging sub-speciality onto the map. As a trainee, the changes have been marked, radical and at times near miraculous. Orthopaedic junior doctors are actually taking time to document AMTS scores (Abbreviated Mini-Mental Test Score) in the admission clerk-in whilst Ortho-geriatricians are culturing a knack of looking at post-op wounds and prescribing post-op venous thrombo-prophylaxis. Continue reading

BGS withdraws support for the Health and Social Care Bill

The British Geriatrics Society calls for the Government to withdraw the Health and Social Care Bill.

Despite the pause in 2011, the Future Forum, and the advice of many health professionals, it has become clear that the proposed legislation is both deeply flawed in detail and deeply troubling in its possible consequences. Our position is informed from the perspective of our members’ knowledge and commitment to the health and community services needed by older people. We are concerned that the Bill does not support the changes necessary to provide integrated, high quality consistent care for our ageing population and has a serious risk of undermining the progress made in recent years.

The BGS remains committed to work in partnership with all health and social care services to ensure our ageing population receives the best care possible. In our view the provisions in this Bill will be a step backwards in attempts to do this. We contributed at all stages of consultation including the outcomes framework and the Future Forum. But the PM’s latest selective summit on February 20th suggests that dissenting voices are no longer welcome. Hence we now call for the Bill to be entirely withdrawn and replaced with urgent discussions to shore up the disruption produced over the last 18 months.

Full statement, February 27th 2012

Professor Finbarr C Martin. President, British Geriatrics Society