Dr Claire Copeland is a Consultant Physician in Care of the Elderly and Stroke Medicine, Forth Valley Royal Hospital, Larbert. She tweets @Sparklystar55
Back in 2014 Scotland was struggling to recruit trainees with 18% of training posts remaining unfilled. While Scotland may be the most beautiful country on the planet (#fact) it’s a vast and largely rural country. This is a unique selling point in some respects however there is the perception that it’s inaccessible and doesn’t have much going on compared to the more densely populated areas of say London, Manchester etc.
There is also the challenge of attracting people into the less ‘glamorous’ specialty that is Geriatrics. This problem isn’t unique to Scotland. A fact recognised by the team behind Association for Elderly Medicine Education (AEME). The founding members of AEME – James Fisher, Mark Garside, and Kelly Hunt recognised a need for high quality education for those delivering care to this older population. Continue reading →
Caroline Whitton is a Geriatrician working in NHS Greater Glasgow and Clyde currently based in the Victoria Infirmary, Glasgow which is soon to be subsumed into the South Glasgow University Hospital. She has several educational roles which include Foundation Programme Director, Consortium Lead for NHS Education Scotland and Associate Director of Medical Education for NHS Greater Glasgow and Clyde.
For me, the adventure began when I was asked to deputise for my Clinical Director at a meeting to discuss junior doctor staffing of a new admissions unit. The meeting was hosted by the medical directorate, and I was the lone geriatric voice amongst a cast of many. From that meeting began a process that has, for the time being, taken over my professional life! Do I regret my initial impulse to go along? No – because it initiated a journey which has enabled me to be involved with the design of a completely new service. It has made it possible for me to influence the way in which I provide care to my patients and deliver training to my junior colleagues.
10% of patients admitted to hospital as an emergency stay more than two weeks, using 55% of all hospital bed days, and 80% of that group are aged over 65 years.
The average age of a hospital inpatient is over 80. Good care for older people in acute care is a key priority for health services.
In 2012 Healthcare Improvement Scotland (HIS) was asked by the Scottish Government to “improve acute care for older people by March 2014”. A review of the published evidence plus the themes coming from the inspections of acute care services for older people suggested there were opportunities for improvement in the care of frail older people coming in to hospital, and that in particular delirium was often undetected with resulting poor outcomes for patients (including higher risks of death or institutionalisation).
Penny Bond is Improvement Support Team Leader in Healthcare Improvement Scotland leading a national programme of work to improve older people’s acute care. She tweets at @opachis. Here she talks about a collaborative national approach to improving the identification and management of frailty and delirium in older people admitted to acute hospitals.
NHS Board Flash Reports
‘Improve care for older people in acute care by March 2014.’ This was the request made to Healthcare Improvement Scotland (HIS) in April 2012. From an improvement perspective this felt like an ‘end world hunger’ type of aim! Given that the vast majority of patients in hospital are over the age of 65 and these numbers are predicted to increase by 50% over the next 20 years we needed to really focus this work by identifying where there were shared priorities and opportunities for improvement. Continue reading →