The Budget was a missed opportunity to help frail older patients stranded in hospital

The President of the British Geriatrics Society commented that the budget ‘failed to address the critical issue of delayed transfers of care for older people by increasing funding for social care’ at the Society’s national conference.

At the BGS national conference on Wednesday (22 November), Dr Eileen Burns, President of the British Geriatrics Society, called for the Chancellor to provide interim funding for social care to help medically fit older patients stranded in hospital wards return to their homes.

Dr Burns commended the government on its additional 10 billion pound capital investment in the NHS and the recent announcement that a Green Paper identifying long term solutions to the social care crisis will be published in the summer of 2018. Despite these measures healthcare professionals remain concerned that the ongoing limitations on social care funding will continue to put intense pressure on the NHS.

The Second BGS Cultural Revolution- and the Living Well SIG

Sir Muir Gray has worked for the National Health Service in England since 1972, occupying a variety of senior positions during that time. He is an internationally renowned authority on healthcare systems and has advised governments of several countries outside the UK including Australia, New Zealand, Italy, Spain and Germany. He tweets @muirgray

The British Geriatrics Society can be proud of the culture change it has achieved by providing leadership in the last seventy years.  When the BGS was founded the prevailing beliefs of not only the public but also the medical profession, were that the problems of older people were due to the ageing process and not due to treatable disease – older people therefore needed “care” rather than accurate diagnosis, effective treatment and rehabilitation. The BGS and individual consultants should be proud of their achievements. There has been a revolution in the care of older people with disease.

Incoming President of the BGS calls for respect for ‘victims of underfunding’

Dr Eileen Burns, who takes office today as the new President of the British Geriatrics Society, has called for public recognition that older people facing delays in discharge from hospital are the victims of underfunding of social care and not ‘the problem’. Dr Burns is urging members of the public, and media, to reject pejorative terms like ‘bed blockers’ and urge the Government to give social care the priority it deserves.

Dr Burns is only the second female President since the Society was founded in 1947. She has been a consultant geriatrician in Leeds for twenty-two years, and is an expert in community geriatrics. The primary focus of community geriatrics is to reduce admissions to hospital, and prevent delayed discharges and re-admissions, by ensuring that older patients receive adequate and appropriate care within their community.

Accessible social care is a key factor in reducing hospital admissions and delayed discharges for older people. According to research published earlier this month by Age UK, the number of older people in England who don’t get the social care they need has soared to a new high of 1.2 million – up by a staggering 48% since 2010.

A radical rethink of care: report from the Parliamentary Committee on Health

Dr Jackie Morris is currently Dignity Champion for the British Geriatrics Society, and a Trustee of the British Institute of Human Rights.

On 23 February, I attended a meeting of the Parliamentary Committee for Health on behalf of the BGS; this particular meeting focused on the challenge of delivering high quality, integrated and compassionate care for older people.

During, the meeting (chaired by Baroness Masham of Ilton), we heard from a varied panel of speakers including Lord Warner, Professor Martin Green, Roy James (President of the Association of Adult Social Services), Caroline Abrahams (Charity Director of Age UK), and Helen Birtwhistle (Director of External Affairs at the NHS Confederation).

“What good integrated care looks like”: the CQC Thematic Review

 

Dr Elizabeth Kendrick is a GPwSI for older people and National Professional Advisor for older people for the Care Quality Commission. For further information please contact elizabeth.kendrick@cqc.org.uk

CQC has begun a review that explores how health and social care services currently work together to deliver care for older people that is integrated.

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

Jill 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’?

Care home residents deserve the best care. The best care is integrated.

Dr Adam Gordon is Clinical Associate Professor in Medicine of Older People at the University of Nottingham.  He works as a community geriatrician and conducts research into models of care delivery in care homes. From 2013 to 2015, he was Honorary Secretary of the British Geriatrics Society.

Care home residents have complex care needs. Between 75 and 80% of residents have memory problems, 57% are affected by urinary incontinence, 42% have faecal incontinence and some 61% require assistance with mobility. The average number of medications per resident is 8 and the average number of medical diagnoses is 6.

Much of the health and social care provided in care homes is excellent, but it is not surprising that things break down from time to time given the complexity of the care problems seen. When things do break down, it is often the failing of multiple parts of the system at the same time. Recent scandals around hydration in care homes have seen residents cut down on their fluid intake because they were worried about accessing enough of the right continence supplies, whilst both health and social care staff failed to recognise the problem until the resident’s health had deteriorated to a critical state.

Health & social care costs: big data, or huge problem?

Rachel Elliott and Matthew Franklin are reporting on behalf of the Medical Crises in Older People (MCOP) research team. Read the first part of their blog on identifying health & social costs here.

As part of a programme developing and evaluating care in older people, our recent study in Age and Ageing reports health and social care costs over a three month period for older people discharged from Acute Medical Units (AMU) by applying unit costs to patient-level data obtained from six different agencies: hospitals, primary care, social care, mental healthcare, ambulance services, and intermediate care. This is the first study to do this in England, but obtaining resource use data from individual services for this analysis took months, which was costly and of no use for real time patient management.

Identifying health and social care costs for older people

Rachel Elliott and Matthew Franklin are reporting on behalf of the Medical Crises in Older People (MCOP) research team at the University of Nottingham.

As part of a programme developing and evaluating care in older people, our team wanted to know the distribution of health and social care costs of older adults discharged from Acute Medical Units (AMU) in England across six care services (primary care, hospitals, intermediate care, mental healthcare, social care, and the ambulance service). This is the first study to do this in England.

Expose the worst – but remember to praise the best

Professor Adam Gordon is Honorary Secretary of the British Geriatrics Society, a consultant geriatrician, and Honorary Associate Professor in the Medicine of Older People at Nottingham University Hospitals NHS Trust.

It can be tempting when faced with inadequate care for an older relative, to believe that all such care is inadequate. As someone who regularly advocates on behalf of older people with frailty, I know that I frequently feel let down by an NHS or long-term care sector that seems ill-equipped to care for older people.  Lots of things can get in the way: cumbersome bureaucracy, lack of expertise and training, a culture that at times seems obsessed with diagnosis and cure at the expense of comfort and care, and at other times seem almost unduly pessimistic about prognosis. This often seems to take place without consideration of the individual choices of patients or their carers, as the system strives hard to stay afloat by maintaining “patient flow”.

There is, in the midst of this, a need to campaign, to educate and to proselytize. We need to share how bad it can get, as a cautionary tale. The work of the families of mid-Staffordshire and of Morecombe Bay has been essential.  The work undertaken by Nicci Gerard and others as part of John’s Campaign, raising the profile of family carers on wards for older people, is something to which we should all be lending our support. The Panorama exposés on the sometimes scandalously poor quality of care in the long-term care sector are necessary. Yet if all we ever do is report the bad stuff, then we all – patients, families, carers and professionals in health and social care – might be left feeling bereft and believe that all is lost.