Who knows what the next 70 years will bring?

Liz Charalambous is a nurse and PhD student. She tweets at @lizcharalambou and is a regular guest blogger for the BGS.

This year heralds the 70th anniversary of the British Geriatrics Society. Founded in 1947, the society sought to alleviate suffering and improve standards in the care of older people.

It seems almost impossible to imagine the world back then: a clunky analogue era of post-war rationing, George VI, the dawn of comprehensive schools, and of course a Labour government planning the inception of our beloved NHS. The future social determinants of health were given a nod to by Beveridge’s post war ‘giants on the road to reconstruction’, namely poverty, disease, ignorance, squalor, and idleness, by the undertaking of a newly introduced welfare state. The grimness of post-war Britain held the promise of a brighter future for all, with government commitment to better access to social housing, employment, social security, education and health. Continue reading

The British Geriatrics Society welcomes plans for strategic approach to funding of care for older people

The British Geriatrics Society welcomes yesterday’s announcement in the Chancellor’s Budget Statement that the Government will be publishing a Green Paper this year on the future financing of social care. We have been calling for a lasting solution to the current crisis and are pleased that there is a clear recognition of the need for a sustainable and strategic approach to the funding of care for older people.
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NHS – A giant Diogenes syndrome

Adhi (V Adhiyaman), geriatrician and Chair of Welsh council of the BGS. Tweets at @adhiyamanv

220px-giovanni_battista_langetti_-_diogenesDiogenes was a controversial Greek philosopher who lived in the fourth century BC. He was a cynic and rejected many conventional ideas and lived in a large clay jar in the city of Athens. He lived in a squalor and rejected ideas of normal human decency.

Diogenes syndrome is a disorder characterized by self-neglect, domestic squalor, apathy, compulsive hoarding of garbage and more importantly lack of shame. The syndrome does not refer to the intelligence or the philosophies of Diogenes but rather refers to the way Diogenes lived. A person with primary Diogenes syndrome is intelligent but aggressive, stubborn, suspicious, emotionally labile and has an unreal perception of life. 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.

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The NHS Benchmarking Network needs your help!

The British Geriatric Society are pleased to announce that our partnership project with the NHS Benchmarking Network is now live for data collection. Care of older people in acute settings is an exciting new project for 2014 which looks at pathways for older people through secondary care.image_mini

The project has been developed in conjunction with the BGS, and it will consider the path older people take through secondary care. The project looks at the journey from A&E through to short term assessment units, elderly care wards and supported discharge processes. Links with other sectors including primary care, community services, mental health and social care particularly at the front and back end of hospitals will be of particular interest and are explored in further detail in the project. Continue reading

You can save lives and money

Paul Harriman has recently published his paper Timely care for frail older people referred to hospital improves efficiency and improves mortality without the need for extra resources in Age and Ageing journal. Today he describes his findings on the OUP blog:oupblog

There is a truism in the world that quality costs, financially. There is a grain of truth in this statement especially if you think in a linear way. In healthcare this has become embedded thinking and any request for increasing quality is met with a counter-request for more money. In a cash-strapped system the lack of available money then results in behaviour that limits improvement. However, as an ex-colleague once said “we have plenty of money, we just choose to spend it in the wrong places”. This implies that if we were to un-spend it in the wrong place we would have plenty of spare cash. Continue reading

A Long and Fortunate Life

Chris Roseveare is a Consultant Physician in Acute Medicine at University Hospitals Southamption, and is Editor of Acute Medicine Journal. He tweets at @CRoseveareshutterstock_958782

Shortly before my grandmother died, at the age of 90, she told me that she felt fortunate: fortunate to have maintained her health for so many years – and fortunate that the NHS had been there for her when she needed it. Not that she had ever been a great user of the Health Service – a thyroidectomy and essential thrombocythaemia required a few tablets, periodic blood tests and infrequent visits to the haematology clinic – but overall Peggy was right to feel lucky.

She was, of course from a generation which had lived through challenging times – she brought up two children, while her husband fought Rommel in North Africa, and endured the subsequent rationing that is hard to imagine in today’s society; she was a tireless fundraiser for the Royal British Legion and Women’s Royal Voluntary Service, for which she was awarded a well-deserved MBE; until her mid-80s she delivered Meals on Wheels, in her Morris Minor, to those Sussex residents for whom time had been less kind. After her own mother had died young, she had to endure the death of her own daughter from ovarian cancer; when her husband suffered a dense left middle cerebral artery stroke she drove daily to his nursing home for 2 years, to sit with him, help with his meals and provide personal care. She would never admit how these events must have affected her: a true exponent of the British ‘stiff upper lip’. Continue reading

Do Mention the F Word: Frailty and Policy

David Oliver is a Consultant Geriatrician in Berkshire and a visiting Professor in Medicine of Older People at City University, London. He is President Elect of the British Geriatrics Society.fffa_long

Frailty is something of an obsession for geriatricians. In a medical tradition based around “single organ” specialities and a branch of medicine which has sometimes struggled to make its identity distinct, its value clearer and its prestige higher, we know that older people with frailty and complex comorbidities are our bread and butter. And that applying skilled Comprehensive Geriatric Assessment, and whole systems, whole person care to a traditionally neglected group of service users defines what we do better than our non-geriatrician colleagues. Continue reading

NICE guidance and the importance of considering multimorbidity

Amit Arora is a consultant physician in care of older people and Chair of the England Council of the BGS. EmergencyAvoidance

Finally, multi-morbidity may be recognized- is this wishful thinking or a BGS victory for our patients?

Whatever it is, it is time for action!

NICE is committed to developing more relevant guidance for GPs that takes into account the complexity of patients they see in daily practice with multiple long-term conditions, the chief executive of NICE told delegates at Pulse Live.

Opening the first day of the conference in London on 29th April 2014, Professor David Haslam said NICE recognized current single-condition guidance was impractical for GPs dealing with patients with multimorbidity. ‘Single long-term conditions – which is the way NHS is organized generally apart from primary care – is the rarity.’ This of course is a cause close to the hearts and minds of many geriatricians. I have myself written about this on this blog and in some submissions to the health agencies in past. Continue reading

Continence: my conscience is clear!

Dipti Samani is a speciality trainee registrar in Geriatric Medicine working in Leicester.continence2

As NHS Change Day approached I thought about what I could do to help raise awareness about the issues that affect my patients. I was in the continence clinic at the time and wondered if it would be too crazy to consider wearing a continence pad for the day… Continue reading