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About the BGS

The British Geriatrics Society is the professional body of specialists in the health care of older people in the United Kingdom.

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BGS Autumn Meeting

Register for the
Autumn 
meeting.
The abstract system has now closed. Abstract Adjudication results will be posted here around 1 August.

 

Geriatrics 4 Juniors



For medical students, foundation year doctors and medical trainees. Discover Geriatric Medicine - Nottingham - 8 October



Pain profiling has potential improve quality of life for older patients

A two part paper published recently in Age & Ageing, the scientific journal of the British Geriatrics Society, reveals that pain profiling in older patients has the potential to improve quality of life, and help target resources to those most at risk of disability. The study also found that the use of new pain profiles, which took into account the impact of pain and its subjective nature, might enable better management of pain, and more accurate predictions of healthcare utilisation among older people. 

The research, ‘Understanding pain among older persons’ examines pain profiles in older patients, and their ability to predict disability, quality of life and help manage healthcare resources. The study, which was conducted by the University of Limerick in Ireland, highlights the fact that pain is a widely recognised problem in older people, and a common reason for enduring long-term disability. The data for the study was gathered from 8,171 respondents, aged 50 and over, living in a community setting. 65% reported not often being troubled by pain. Of the 2,896 respondents often troubled by pain, four pain profiles were identified using questions such as ‘does the pain make it difficult for you to do your usual activities?’, ‘do you have a number of pain sites?’ and ‘are you taking medication to control the pain?’. 

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In memoriam - Kate Granger

 It is with profound sadness that the BGS shares the news that our member, Dr Kate Granger has passed away over the weekend.

Kate was only 34 when she died, having battled cancer since 2011. 

Kate became well known to BGS members when, during the course of her very difficult treatments, she encountered health professionals who failed to introduce themselves when dealing with her. 'I felt like I was just a diseased body', she said in both the books she wrote about her experiences. These books, entitled 'The Other Side of the Story' and 'The Bright Side' chronicled her journey through the health system. The proceeds from the sale of the books were donated to charity. In all, she raised £250k for charity. 

Speaking of her achievements, Chris Pointon, Kate's husband said that although Kate's death at the age of 34 was cruel, 'in those 34 years, she made a huge difference. She didn't think she had achieved a lot in her life but her legacy will remain for many, many years to come and we have many ambassadors across the globe that will make sure the names Kage Granger and 'hello my name is' will always be remembered'. 

When Kate addressed the BGS spring conference in 2014, she thought she had only months to live, but her determination to drive her 'hellomynameis' social media campaign sustained her for two more years. Her renown grew steadily over that time. Apart from being awarded the BGS President's Medal (the only one ever awarded to a trainee - as she was at the time), she was recognised in the Honours list with an MBE, and she was, for several years running, named by the HSJ, as being one of the most inspirational young leaders of our time. This accolade is borne out by Felicity Jones, past medical students' representative on the BGS Trainees' Council who said after she met Kate: 'Whilst helping with the microphones [at the BGS Spring meeting in 2014], I found myself chatting to Dr Kate Granger, who is rightly seen as one of the most inspiring doctors of our time, before she gave a powerful speech about the use of social media and the importance of compassion in medicine. Having long admired Kate and being a wholehearted supporter of these messages, it was amazing to meet her, and to see many others in the audience also deeply affected by her speech.' 

Our heartfelt condolences to Chris, Kate's family and to many BGS members who grew close to Kate and who will have been deeply affected by her passing. Geriatric Medicine is the richer for having had her in the speciality and the BGS was fortunate to have had her as a member. She will be long remembered and sorely missed.

See: Kate Granger inspired all of us in the NHS to be more compassionate (Guardian)

NHS Protect Report

Recent publicity around the NHS Protect report on assaults on NHS staff over a 5 yr period focused on the finding that over 75 yr olds were frequently involved in such assaults (“perpetrators”) and substantially failed to identify the common underlying cause- that is delirium or behavioural and psychiatric symptoms of dementia. 

Stigmatising and blaming older people in this way is extremely unhelpful.

We link here to two resources- blogs by Dr James Wood and Dr Duncan Forsyth which “call out” the media for the pejorative way in which the NHS Protect report was interpreted, and which summarise the 2014 NICE guidelines on the prevention, identification and management of dementia. 

There are a number of guidelines and videos linked from James’s blog which staff members can use as teaching aids- they are added below, with a link to the NICE guidelines.

We still have a long way to go in the understanding of one of the commonest complications of acute hospital admission in older people. The reports in both print, on-line, TV and radio indicated complete misunderstanding by journalists of the condition. Nor can we accept the implicit ageism of these articles which fail so completely to understand the distressing nature of delirium to the patient, their family and staff and which instead offer only blame to the older person suffering the illness.

Let’s redouble our efforts to ensure that in all of our hospitals the nature of delirium is understood and that we are spreading the word- it’s preventable and treatable.

Reources:

https://www.nice.org.uk/guidance/qs63

#Icanpreventdelirium

https://www.youtube.com/watch?v=BPfZgBmcQB8&feature=youtu.be by Mani Krishnan (@psychinformatic)

www.knowledge.scot.nhs.uk/improvingcareforolderpeople/think-delirium.aspx

 

An invitation to joggers and runners: join Team AEA to help stop elder abuse

With approximately 500,000 instances of elder abuse occurring each year in the UK we are constantly seeking ways in which we can combat elder abuse. As many of you know, Action on Elder Abuse provides direct support through our helpline and EARS scheme and reaches many more through our awareness raising activities and policy work.

AEA has three upcoming running events that are commencing later on in the year and it invites you to take up the opportunity to fundraise for Action on Elder Abuse and help to put a stop to abuse of our older people throughout the UK.

Are you ready to make a difference? Whether or not you have ever considered taking part in fundraising for charity why not take the plunge this year? It doesn’t matter if you have never run before, or feel that it would be a struggle to raise the money because the AEA team will be on hand with training tips and fundraising ideas.

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New resources from NICE

NICE has published  two new resources to support the implementation of the guideline on Older people with social care needs and multiple long-term conditions

Tailored resource

This resource will help you to implement one of the key guideline recommendations - that older people with social care needs and multiple long-term conditions have a ‘single, named care coordinator who acts as their first point of contact’. Drawing on the discussions from 3 focus groups facilitated by Age UK Sutton, which involved older people living in their own homes and in a care home, it presents the expectations that older people have of this role.

Tailored resource - ‘Just one person’: the named care coordinator role from the perspective of older people

Roundtable report

NICE held a roundtable event in January 2016 to identify how the guideline can be used. This report summarises the discussion, and sets out practical examples and ideas to implement best practice. You can use the report to see how others are implementing the guideline and to get ideas for how you might use the guideline to improve local practice..

Making progress on personal joined up support: report of a roundtable discussion

Both resources were developed the NICE Collaborating Centre for Social Care (NCCSC), a partnership led by SCIE. 

London mayor calls for ‘immediate halt’ to removal of bursaries

Nursing Times: Mayor of London Sadiq Khan has called for “an immediate halt” to government plans to replace healthcare student bursaries with loans, warning the move would hit nurse recruitment and healthcare services in the capital. In a letter to the Department of Health, he warned London “will be impacted heavily by the decision to end the bursary system” and it that it would make recruiting and retaining nurses and midwives harder due to the higher cost of living.

The mayor’s appeal comes after the London Assembly passed a motion calling on him to urge the government to stop it plans, which will from autumn 2017 see students have to take out loans for both tuition fees and living costs. 

The letter to the DH refers to a recent Royal College of Nursing survey, which found four in ten nurses employed in London may leave by 2021 due to the cost of housing.

Why the latest Alzheimer's 'cure' might be too good to be true

Independent: Many might have welcomed the latest reports that a cure for Alzheimer’s could be just around the corner, to scrub the disease from the planet for once and for all. Currently, patients’ options are limited to treatments that reduce memory loss by replacing neurotransmitters eaten away by the condition. Now, researchers working in the US – where over $1.3 billion has already been spent on investigating dementia – believe that they have developed a “breakthrough” vaccine which uses the immune system’s antibodies to attack proteins believed to cause Alzheimer’s disease. 

Following tests on mice, experts from the Institute for Molecular Medicine and the University of California, Irvine published a paper on a vaccine that targets both beta-amyloid and tau proteins linked to the disease. 

“If we are successful in pre-clinical trials, in three to five years we could be well on the way to one of the most important developments in recent medical history,” Flinders University School of Medicine Professor Nikolai Petrovsky, and co-author of the study published in Nature’s 'Scientific Reports' journal, recently said.

It certainly sounds revolutionary – particularly to those desperately afraid of the disease. But experts working in a field where only 0.4 per cent of the almost 250 potential treatments for dementia tested between 2002 and 2012 have been successful are cautious to celebrate. Some even warn that harnessing the immune system against Alzheimer’s could be dangerous.  

'Independent Age' Charity raises questions about the IFS report on 'pensioners prospering'

Politics Home: If you are one of the estimated 1.6 million pensioners in poverty in the UK, you might be forgiven for hanging on to your copy of today’s IFS report on Living Standards and putting it on the fire this winter to save on your heating bills. Not that it isn’t sober and thought-provoking research, analysing masses of data to raise important concerns about working age poverty. Most older people – many as parents and grandparents - will share those concerns. But the sheer scale and complexity of its analysis inevitably leads to simplification of its findings and the simplest of those can be seen in the BBC report:  ‘Young suffer as pensioners continue to prosper’.

It will be little comfort to you that your chances of being poor has fallen and that rates are higher in other groups. You are still one of the many older people trying to survive on less than £138 a week. You might also wonder why everyone over the age of 60 is regarded as one large homogenous group, with no attempt made to distinguish between the younger generation and the older, ‘silent generation’ of those 75+ among whom average incomes are much lower. Is that a failure of the data, or the analysis, you might wonder. Perhaps it is just easier to think of all people over 60 as ‘older’.

Even if you’re not in poverty, you might be annoyed that parts of the report are not explored more. For example, the report explains there are three reasons why fewer pensioners are in poverty: benefits, pensions and work income. The increase in private pensions cited is - at least in part - a result of people choosing to save more during their working life. And the final reason pensioners are less likely to be in poverty is that more of them are working beyond retirement age – nearly 1 in 10 of them. Again, you might think that pensioners continuing to work, support themselves and pay tax might be a source of congratulation rather than reproach.

Health budget rise 'less than was promised'

BBC: Ministers in England have given the wrong impression about how much extra they are spending on health, MPs say. The government made big play of the extra £8.4bn on top of inflation it was giving the NHS this parliament when it unveiled its spending plans last year. But the Health Select Committee said the true figure was about £4.5bn.

The MPs said a different definition of spending was used to give the idea of more funding. Ministers have rejected the accusation. The cross-party group of MPs said instead of focusing on the whole health budget ministers highlighted the amount going to the frontline via NHS England.

In 2015-16 that was about £101bn, but that ignored £15bn of money set aside for other aspects such as training and public health.

Foreign NHS workers must be assured they are still 'welcome' after Brexit vote, Simon Stevens says

Foreign NHS workers must be given “reassurance” by the Government that they are still “welcome in this country”, Simon Stevens says today. Writing in The Daily Telegraph, the NHS chief executive calls on Theresa May’s new Government to protect the rights of all international employees in the wake of the vote to leave the European Union. Mr Stevens says that Britain’s NHS relies on “committed health professionals from other countries”.

Setting out a post-Brexit blueprint for the health service, Mr Stevens also says that money should be diverted from hospitals to GP surgeries to help save the NHS. He calls on Mrs May to use the EU referendum as an opportunity for “radical change” in the health service. Urging the Government to focus resources on GPs rather than hospitals he says that “headlines about hospital deficits obscure the fact that over the past decade their share of funding has grown rapidly at the expense of primary care”.

And he warns that GP surgeries and hospitals across the country are “overcrowded and clapped-out” and calls on Mrs May to set up new infrastructure fund to replace buildings “buildings in need of a makeover if not a bulldozer”.

NHS Finances outside the EU

Health Foundation analysis of the impact on NHS finances of the UK leaving the European Union

The vote to leave the EU comes at a time when the NHS is facing a substantial financial challenge. The government’s pre-referendum plan to achieve a fiscal surplus by 2019/20 already means that there is less money available to help meet health system funding pressures than in previous decades. The 2015 comprehensive spending review confirmed the period from 2009/10 to 2020/21 as the most austere decade that the NHS has ever experienced.

The funding available for the NHS is highly dependent on the strength of the national economy; we cannot know with certainty how the UK’s decision to leave the EU will impact, with so much depending on the details of the deal negotiated with the remaining EU members and future trade arrangements with other countries. The major of forecasts in the event of a Brexit, forecast a negative effect on the economy. There was only one published forecast, from a member of the Economists for Brexit group, that didn’t estimate a negative impact.

The Health Foundation analysis uses the most optimistic scenario from the National Institute of Economic and Social Research (NIESR) modelling. This assumes that the UK joins the European Economic Area (EEA). In the short term this would see the economy grow at an average of 1.5% a year between 2015/16 and 2019/20, instead of 2.1% without leaving the EU. This would mean a total loss to the economy of £43bn in 2019/20 (£835m a week).

Click here to read the full report. See also: The UK voted to leave the EU: what now for the NHS? (NHS Confederation)

Home care: delivering personal care and practical support to older people living in their own homes

This NICE guideline covers the planning and delivery of person-centred care for older people living in their own homes (known as home care or domiciliary care). It aims to promote older people's independence and to ensure safe and consistently high quality home care services. The Care Quality Commission uses NICE guidelines as evidence to inform the inspection process.

Recommendations (click here for more detail)

  • ensuring care is person centred
  • providing information about care and support options
  • planning and reviewing home care and support
  • delivering home care, including recommendations on the length home care visits
  • joint working between health and social care
  • ensuring safety and safeguarding people using home care services
  • recruiting, training and supporting home care workers

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