‘A destructive vicious circle’: what does the future hold for health and social care?

age-ukJill Mortimer is Age UK’s Health and Care Policy Adviser and tweets at @Age_UK.

What’s really happening in health and social care services? Over the last few years, we used in Age UK’s Care in Crisis campaign to document the devastating budget cuts that meant fewer and fewer people were getting public support for help with their day to day activities.

But what about the NHS? Hasn’t it been protected through the last five years of cuts in public services? If so, what lay behind last year’s winter crisis? And why is Monitor, the health services financial regulator, now talking about the ‘worst financial crisis in a generation’?

Continue reading

General election manifestos: how does each party measure up on care for older people?

5695179697_5af8e997ec_oEd Gillett is Communications & PR Manager at the BGS. Following the publication of each major political party’s election manifestos, Ed assesses how they compare to the BGS’ own pre-election call on health and social care for older people.

Last week saw the publication of the Labour and Liberal Democrat election manifestos, following hard on the heels of those from the Conservatives, Greens and Ukip. We now have a clearer picture of each party’s vision for health and social care.

But how seriously is each party taking the issue of excellent care for older people, and how do they measure up to the Society’s own pre-election policy work, in which we highlight the six key decisions facing an incoming government?

Continue reading

The NHS England Five Year Forward View: part 2

DAVID OLIVERThis is the second of two blogs by BGS President David Oliver, focusing on the recent launch of the NHS England Five Year Forward View. Read part one here.

In my blog on 24th October, I described the crucial marker that this document has laid down for the mid-term future of English Health and Care services and the “big picture” implications. Here I want, in the words of the “Dragon’s Den” voice-over, to “drill down” into some of the key features and their implications for fellow BGS members.

Whilst we deal with the consequences of preventable ill health in older age, the report’s focus on prevention across the lifecourse is commendable. We know that there are major inequalities in life expectancy and healthy life expectancy at 65 and that around half of all poor health in older age is attributable to life style factors. So its good to see a clear challenge to government around diet, obesity, alcohol, cigarettes and exercise and the need to move away from “nudge” and “responsibility deals” to more proven preventative interventions.  We also welcome the greater focus on local government’s role in reducing social isolation or improving housing for older people. And on the untapped contribution that volunteers can make to helping older people remain connected and active – as well as the benefits  for older people who are volunteers. Continue reading

The NHS England Five Year Forward View: A crucial document for our speciality, for the care of older people and for Health and Care Services in England.

David Oliver is President of the BGS, Visiting Fellow at the King’s Fund and Consultant Geriatrician at the Royal Berkshire Hospital, Reading. In part 1 of a 2-part blog, he discusses how the NHS “Five Year Forward View” is important for people involved in the care of older people.

October 23rd 2014 is memorable to me, as it’s my 23rd wedding anniversary. It’s also now of significance to the rest of us, as the date that NHS England’s “Five Year Forward View” plan was published. I realise not many of you will have had the time or necessarily inclination to read it, though at only 39 pages it’s an easy canter.

I also know it hasn’t attracted much Twitter activity from fellow BGS members. But it’s a document which I suspect will have far reaching influence and implications for the services we all work in. These implications seem largely positive. Let me explain why.

Continue reading

Will volunteer success deliver the elusive Holy Grail of PPI?

Liz Charalambous is a qualified nurse on a female, acute medical HCOP (Health Care for Older People) ward at Queen’s Medical Centre, Nottingham University Hospital Trust.

Having nursed in different areas for over 30 years, she currently balances her time between clinical work, research into the prevention of delirium and studying for a MSc. in Advanced Nursing at the University of Nottingham.

Here she discusses whether PPI (Patient and Public Involvement) can contribute to person-centred care. Liz tweets from @lizcharalambou

Recent media coverage highlights loneliness in the elderly population and how some organisations are taking steps to combat this, such as the ‘Be a friend’ campaign launched recently by Friends of the Elderly http://www.beafriendtoday.org.uk/ . Patients and relatives must breathe a sigh of relief that when their loved one is admitted into hospital, at least they will be surrounded by others and therefore not at risk of loneliness.

Unfortunately, this is not always the case. Despite NICE guidelines for Delirium (2010) https://www.nice.org.uk/guidance/cg103 and Dementia (2006) http://www.nice.org.uk/guidance/cg042 calling for the involvement of families, as well as the much-vaunted Holy Grail of PPI (Patient and Public Involvement) post Francis, many older people remain at risk of confusion and developing delirium purely by virtue of the fact they are over 65 years of age and clinically unwell. Staff are very often tied up with the clinical side, and rightly so. A blocked airway, arrhythmias, acute kidney injury and clinical deterioration remain a priority over holding someone’s hand. Continue reading

“We’re onto something big here” – where next for the Barker Commission?

Ed Gillett is the British Geriatrics Society’s new PR and Communications Manager. He tweets at @ehgillett and @gerisoc

barker-commission-cover

Having only joined the BGS in August, I got my first taste of a large-scale event last week at The King’s Fund, with the launch of the final report from the Barker Commission on Health & Social Care.

I’ll be honest: it was a slightly intimidating experience initially. The sheer weight of intelligence and experience in the room was something to behold, from senior NHS directors and media figures to the heads of numerous NGOs, thinktanks and specialist organisations. It was a room full to the brim with big names and heavy hitters; the only notable absentees were the major political parties, at least on the Commons side of things.

It immediately became clear why this was the case, on both counts. As Dame Kate Barker outlined the core recommendations of the report, I was struck by how bold and ambitious they were; surely the sort of thing which demands high-level attention and debate, but which could also give your average Whitehall spin doctor the odd heart palpitation.

Continue reading

Hypertension in people with dementia – what should we do?

Tomas Welsh is a Clinical Lecturer in the Medicine of Older People at the University of Nottingham and a recent recipient of a BGS grant to support research in geriatric medicineHIND

Antihypertensive therapy is effective even in the oldest old. However, the large trials of antihypertensive medications, even in older people, frequently excluded people with dementia. This causes difficulties in applying these findings to many of our typical patient group.

People with dementia are more likely to be physically frail, are at higher risk of adverse events due to polypharmacy and are more likely to experience orthostatic hypotension than their cognitively intact peers.  There is reason to suspect, therefore, that the risk-benefit ratio of treating hypertension may be different in this group and many clinicians intuitively feel this to be the case.   Continue reading