The British Geriatrics Society is the professional body of specialist doctors, nurses, therapists and other professionals concerned with the health care of older people in the United Kingdom.
Age and Ageing is the British Geriatrics Society’s international scientific journal. It publishes refereed original articles and commissioned reviews on geriatric medicine and gerontology.
The BGS wishes to recruit a fully UK-qualified Accountant with substantial post-qualification experience for this senior management position, which may be filled full-time or part-time.
Reported by the BBC, 26 Oct 2017: The number of patients in England being readmitted to hospital within 30 days of discharge has risen by nearly a quarter in the last four years, a watchdog has said.
Figures compiled by Healthwatch suggest one in five of these potentially distressing readmissions happen 48 hours after being sent home. The watchdog warns patients may be being rushed out early. NHS England says it is impossible to know the reasons for the readmissions. An emergency readmission occurs when a patient needs to go back into hospital unexpectedly for further treatment, within 30 days of having been discharged. Readmissions in such a short space of time raise concerns about patients being discharged unsafely, and about the pressure on hospitals to free up beds.
Reported by NHS Improvement (17 October): An evidence-based framework to support and enable directors of nursing and medical directors to achieve ‘outstanding’ care standards for those living with dementia during their stay in hospital.
The framework consists of eight standards and draws on learning from organisations that have achieved an ‘outstanding’ rating from the Care Quality Commission, and integrates policy guidance and best practice with opinion from patients and carers. The latter was captured through existing resources, including Healthwatch UK (2017), Patient Voices, the Alzheimer’s Society and meeting people and their carers living with dementia.
Designed to be implemented using quality improvement methodology, embodying the principle of continual learning, We recommend it forms part of your quality improvement programme. The principles of the framework apply to all services and you should adapt it to meet your local population and workforce needs.
Reported in Care Home News (18 October): A care home in West Yorkshire has reduced the chances of its residents having falls and accidents by trialling an innovative program designed to improve balance.
Seven residents from Czajka Care Group’s Brookfield Residential Care Home took part in a new training program using Nymbl – a comprehensive system for measuring, tracking and improving balance – and were found to have an increased level of independence, activity participation and enjoyment after just four weeks.
Konrad Czajka, managing director of Czajka Care Group, said: “The Nymbl team were great. They worked with our staff to carry out pre-training evaluations using the Nymbl app, with all seven residents aged between 55 and 101, to assess their Balance Index. The residents then attended four weeks of group balance training classes with a coach.”
He added: “We were very impressed with the results of the Nymbl programme and plan to offer the training at another one of our homes very soon. We are always looking for new and innovative ways to make sure our residents feel confident and capable in their home environment.”
Post-training evaluations were conducted to see improvements in the resident’s balance. The results showed that every resident who completed in the training classes improved their Balance Index. The increases ranged from a four per cent to 24 per cent improvement, with residents who attended the most classes, achieving the highest improvement in their balance.
One resident who participated in the program said: “Knowing that my balance has improved is really important, as it will help me to stay more independent as I age.”
Old age is not for taking it easy and pensioners must ‘play their part’ in keeping active to avoid becoming a burden to the healthcare system, experts have said.
Writing in the British Medical Journal, doctors and ageing charities called for a shift in the ‘prevailing attitude’ which views exercise as an activity only for the young. They called on elderly people to ‘understand their role’ in reducing demand for social care by staying physically fit.
Figures show that one quarter of British women and 20 per cent of men do no activity at all during the week, let alone the recommended 150 minutes, while some studies have estimated that just two per cent of older adults meet weekly exercise requirements.
Lead author Scarlett McNally, a consultant orthopaedic surgeon, at Eastbourne District General Hospital, said research had shown that exercise can restore physical ability to that enjoyed a decade earlier.
“We need to challenge the idea that old people should rest,” she said. “People need to keep active however old they are.
“They need to increase activity. Every adult should do a minimum of 150 minutes of moderate physical activity every week and twice weekly strength and balance training.”
Reported by the Public Sector Executive (18 October): The LGA says a new report on delayed transfers of care (DTOCs) show that the government must allocate more funds to social care services in the Autumn Budget.
An Age UK study found that almost four million bed days have been lost since 2011 due to problems putting patients into community care once they have received hospital treatment, with the number still on the rise.
The largest increase was between 2015-16 and 2016-17 when a 27% increase was recorded in the number of beds being taken by people who could be moved to other arrangements. In fact, in the last year more than 950,000 days were lost, which has an estimated cost to the system of £173m. The LGA disputed the cause of delays, asserting that nearly 60% of all delayed transfers are down to patients waiting for NHS services or assessments rather than places in care homes.
“Councils are doing all they can to try and help people live independently in their communities and reduce demand on hospitals, said Cllr Izzi Seccombe, chairman of the LGA’s Community Wellbeing Board.
“But with unprecedented funding cuts since 2010 and social care services facing a £2.3bn funding gap by 2020, this is becoming increasingly difficult. That is why the need for the government to use the Autumn Budget to reform and fully fund social care is urgent.
“The extra money for social care announced in the Spring Budget was a step in the right direction, but this was one-off funding and not a long-term solution.”
Thousands of people treated in hospital every year are kept in longer than medically necessary because of administrative delays or a lack of available care in the community. This causes unnecessary distress for patients and places additional strain on the NHS. Yet tackling the underlying reasons for the delays, whilst also ensuring every patient has a positive and safe experience of being transferred between services, is not straightforward.
Although the evidence was hard to hear at times, the network's Safely home report played an important role in galvanising much needed system-wide leadership. Since publication there have been encouraging changes at both a national and local level. However, with a rising population of elderly people, and the cost of care going up it’s not surprising that key indicators of poor patient experience such as the numbers of delayed transfers of care have hit record levels.
To help assess progress from the patient perspective two years on from Safely home, this briefing brings together what 46 local Healthwatch have heard from over 2,000 people about the discharge process since. Whilst there were numerous positive stories about people’s experiences transferring between hospitals and care in the community, it is clear that there is still significant work to be done to ensure discharge is a good experience for everyone. In particular:
People still don’t feel involved in decisions or that they have been given the information they need.
People continue to experience delays and a lack of co-ordination between services, highlighting specific problems with being given medication and transport services.
People feel left without the services and support they need after being discharged.
The report explores these points further in this briefing and highlight where local Healthwatch have been working with partners across health and social care to make changes. If adopted more broadly, these examples have the potential to improve people’s individual experiences and ease some of the broader pressures on the NHS. It also explores the need to carefully evaluate the introduction of such initiatives, in particular the new target to reduce delayed discharges set out in the Mandate to NHS England, to ensure they are having the right impact.
Finally, this briefing seeks to outline how the move towards greater integration of services provides a perfect platform from which to fix the discharge problem once and for all.
The slides from the National Frailty conference are now available for professionals who are members of the future NHS collaboration platform / Supporting Older People living with Frailty in Primary Care. If you are not a member of this platform you may access them too.
If you would like an invitation to join this collaboration platform please email
Following the National Dementia Strategy and the Government’s 2020 Dementia Challenge dementia is a priority area for NIHR research funding with a target of increasing the numbers of participants with dementia into clinical research trials to 10% of this patient group. The NIHR has been supporting recruitment of people living with dementia through the NIHR Join Dementia Research register, the ENRICH Engaging Research in Care Homes network and the NIHR Clinical Research Network DeNDRoN. Focused funding calls are also increasing the breadth of research and increasing capacity in this area. Recruiting people living with dementia to research studies however can be challenging. This paper discusses what researchers need to consider when planning a study involving patients with dementia.
Many people with dementia will not have capacity to give informed consent to take part in research. The Mental Capacity Act 2005 (MCA) governs how we decide whether a patient has capacity. The MCA is a very clear piece of legislation and before conducting research involving patients living with dementia, you must become familiar with its content, particularly sections 30 to 34 which cover research. Your knowledge of the act needs to be demonstrated in any funding or research ethics application.
Intermediate care focuses on the person's own strengths and helps them realise their potential to regain independence. This new guideline from NICE covers referral and assessment for intermediate care and also supports providers to develop a person-centred approach and to deliver efficient and cost-effective services. It has been developed by the NICE Collaborating Centre for Social Care, a partnership led by SCIE.
This guideline covers referral and assessment for intermediate care and how to deliver the service. Intermediate care is a multidisciplinary service that helps people to be as independent as possible. It provides support and rehabilitation to people at risk of hospital admission or who have been in hospital. It aims to ensure people transfer from hospital to the community in a timely way and to prevent unnecessary admissions to hospitals and residential care.
This guideline includes recommendations on:
core principles of intermediate care, including reablement
supporting infrastructure
assessment of need for intermediate care
referral into intermediate care and entering the service
The powerpoint files supporting presentations at the September 2017 BGS Falls and Postural Stability Conference will be made available over the next week as and when presenters authorise publication. The files are in secured PDF format and will remain on the BGS website for two years.
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Age and Ageing is the British Geriatrics Society’s international scientific journal. It publishes refereed original articles and commissioned reviews on geriatric medicine and gerontology.