How (I try!) to avoid a hospital admission for someone with frailty

Dr Amy Heskett is a Speciality Doctor working in a Community Geriatrics team within West Kent called the Home Treatment Service. This team works alongside paramedics, GPs and district nurses to prevent unnecessary hospital admissions for people with frailty, multiple comorbidities, caring responsibilities or as part of end of life care.  The home visits use bedside testing and a multi-disciplinary approach to provide management of many acute medical presentations in a home-setting.  The development of these holistic plans requires a creative approach and the experiences often generate tweets @mrsapea and blogs at communitydoctoramy.wordpress.com

The bag I take on every home visit has numerous pockets with endless equipment and forms required at my fingertips. I clip the same badges and emergency kit to myself at the start of every shift and I take this order and strict routine with me into environments over which I have little control.  It is within this mix of structure and chaos that the creativity to manage conditions and sometimes crises within a community setting arises.

Publications and conferences have explained the importance of avoiding unnecessary hospital admissions (especially for those with frailty) and commissioners require data on the number we have achieved.

A Taste of the BGS

Fran Kirkham is an F2 doctor at the Royal Sussex County Hospital in Brighton, having graduated from the Cambridge Graduate Course in Medicine in 2016. She originally did an English degree at Cambridge University and worked in PR and Communications for 7 years. She hopes to pursue a career in Community Geriatrics.

“So we drove on toward death through the cooling twilight.”
~ The Great Gatsby, F. Scott Fitzgerald

An FY2 taster week can have a multitude of meanings. For some, it offers a reprieve from their mundane day job, almost as desirable as annual leave. For others, it is an opportunity to try a specialty that piqued their interest as a student. Yet others use it for cynical CV-building, knowing exactly to what profession they aspire and ‘proving commitment’ by spending an extra week doing the job they plan to do for the next 40 years. This may gain marks on the flawlessly-designed points-based applications which determine our chances of working in a specialty that bears any resemblance to our future career hopes or a location which is vaguely practical. Of course, a week is not realistically enough to get a sense of any job, nor ‘prove’ commitment to anything. But, as with many things in the NHS, this is the system in which we operate, so we make the best of it.

Old People’s Home for 4 Year Olds

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 Channel 4 programme in which she appeared, Old People’s Home for 4 Year Olds. She tweets @geri_baby

I’ve always had a soft spot for care homes. As a child I would occasionally go into work with my Mum and meet some of the old ladies she talked about. When I was older I started work in the same nursing home as a kitchen girl on Saturdays, and then later progressed to health care assistant. I remain proud of my training record from that time, showing I am competent to deliver personal care, clean dentures and cut nails.

This is why I was excited when an approach came from CPL productions, who were looking for geriatricians to be involved with a television programme they wanted to make about introducing children to a care home environment.

Autumn Speakers Series: Benchmarking Practice in UK Long-term care, can we make it work?

Adam Gordon is Clinical Associate Professor in Medicine of Older People at the University of Nottingham and a Consultant Geriatrician at Derby Teaching Hospitals NHS Foundation Trust. He is a specialist advisor to the East Midlands Academic Health Sciences Network Patient Safety Collaborative on Care Homes and will be speaking at the upcoming BGS Autumn Meeting in London. He tweets at @adamgordon1978

Contrary to what might be gleaned from the lay media, the quality of care received by residents in care homes – whether from care home or National Health Service staff – is frequently exceptional.  Care home residents are amongst the most complex recipients of care within the health and social care system and so they can stretch even the most capable and dedicated of staff. It is therefore, perhaps, unsurprising that things do not always go to plan – even in the best of homes. There are also, undoubtedly, examples of care homes where things go wrong more frequently – where shortcomings in care are not so much sporadic, as systematic. This is unacceptable.

Join us at the BGS Autumn Meeting for a warm Glasgow welcome!

The local organising committee in Glasgow have been preparing for the last two years to welcome the BGS Autumn Meeting in November. We are delighted to have such a varied and stimulating programme and are hoping for a well attended, stimulating and interactive conference where good ideas about innovative new services and research programmes will enthuse the membership in their ongoing care of older people in the United Kingdom.

Getting out of our box – subspecialty training in Community Geriatrics

Jenny Thain is a Specialty Trainee and Wei Mei Chua is a recently appointed consultant in Geriatric Medicine.  Jenny is based in Nottingham and Wei in Derby, UK.  Both took part in a newly designed Specialty Training Rotation in Geriatric Medicine at Nottingham University Hospitals in 2012-2013. Here they share their experience

In August 2012 we were privileged to take up the first dedicated specialty training post in Community Geriatrics in the UK. We were, at that time, two less-than-full-time trainees in the East Midlands region, and both of us were in the latter stages of our training. Over the years we had participated in the odd community session, such as domiciliary visits and community hospital ward rounds. But it was only when we took up this post – which lasted a year – that we discovered the extensive nature of the sub-specialty and what it had to offer.

Move Aside, Geriatrician!

Keith Miller is a GP in Leeds and a member of Leeds West Clinical Commissioning Group. He tweets at @keester76

We all know we have an ageing population. We stare with trepidation at the impending challenges of the ageing baby-boom generation, and the increasing numbers of people living with multiple long-term conditions. We also know that the NHS is developing through a time of unprecedented change, and the financial efficiencies it must realise require fundamental reorganisation of the way we have come to deliver services to our populations. Primary and community care are the answer.