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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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Call for Abstracts

Call for Abstracts for the BGS 2016 Autumn Meeting to be held in Glasgow, 23 - 25 November 2016. Deadline 17:00 on 15 June (extended from 1 June). Click here to submit an abstract if you are presenting your work for the first time.

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Age & Ageing Journal

Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology.

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Early intervention can reduce elder abuse by family carers according to new research

BGS, 25 May 2016: Research published in Age & Ageing, the scientific journal of the British Geriatrics Society, reveals that over one-third (36.8%) of family carers engage in behaviours that may act as early warning signs. They may predict more seriously harmful future psychological or physical abuse of an older person in their care. Early identification and intervention with family carers involved in these types of "precursor" behaviours would help prevent more serious elder abuse in future and improve quality of care. 

The study, which was funded by the Health Service Executive as part of the work of the National Centre for the Protection of Older People (NCPOP) at University College Dublin, found in a national survey that over a third of family carers (35.9%) reported engaging in potentially harmful behaviour with verbal abuse being commonly reported. The most frequently reported behaviour was ‘using a harsh tone of voice, insulting or swearing at the older person or calling them names’ and was reported by 12.6% of the carers. This was followed by ‘screaming or yelling’ in 8.2%, with 4.8% of carers reporting threatening older relatives with a nursing home placement or stopping care or abandoning them (4.0%). Eight percent of carers indicated that they engaged in physical potentially harmful behaviour and approximately 6.2% felt ‘afraid that they might hit or hurt’ the person they cared for. A total of 3.5% of carers reported ‘roughly handling’ and 1.4% reported that they had ‘hit or slapped’ the older person. 

The report suggests that potentially abusive behaviours, including physical abuse, can act as a precursor to more serious elder abuse. Many family carers may not be aware that their behaviours have the potential to be psychologically or physically harmful. This lack of awareness highlights the importance of family carers receiving the support and skills they need to manage difficult caregiving situations, as well as the ability to recognise when they should seek help. The report concludes that, as the main providers of community care, greater emphasis should be placed upon ensuring that family carers receive adequate training and that community-based professionals, such as public health nurses, GPs, social workers and home care staff, should be given the skills to recognise behaviours that might lead to more serious cases of elder abuse.

Attracta Lafferty, one of the lead authors of the Age & Ageing paper, said: "Health and social care professionals working with older people and their carers need to be alert to the 'tell-tale' signs of potentially harmful behaviours, so that appropriate help can be sought, to prevent serious cases of elder abuse from developing. Family carers should also recognise when these behaviours occur, so that they know at which point they should seek help from the relevant services and carer organisations, and avail themselves of the information, training and support services offered.”

Why is it more difficult than ever for older people to leave hospital?

Professor David Oliver blogging for the King's Fund: Discharging older patients from hospital, the National Audit Office (NAO) report published today, focuses primarily on those patients deemed ‘medically fit for discharge’ but who are stranded in hospital.

The NAO report looks beyond the official data on delayed transfers of care at the underlying issues affecting this group of patients.

Between 2013 and 2015, official delayed transfers of care rose 31 per cent and in 2015 accounted for 1.15 million bed days ­– 85 per cent of patients occupying these beds were aged over 65. The NAO estimates that the real number of delays is around 2.7 times higher than those officially counted. No wonder delayed discharges topped the list of concerns reported by NHS finance directors in The King’s Fund’s latest Quarterly Monitoring Report

Waiting for social care was the biggest cause of this sharp rise. Since 2010, waits for home care packages have doubled and waits for beds in nursing homes increased by 63 per cent. This isn’t surprising given the increasing number of old, frail and medically complex hospital patients, coupled with 10 per cent cuts in real-terms funding for social care over the past five years. The Barker Commission warned of the potential impact on the NHS of inadequate social care funding and the anomaly between free-at-point-of-use health care versus means-tested and highly rationed social care.

But it’s not just social care. The NHS Benchmarking national audit of intermediate care estimates that we only have around half the intermediate care places we need nationally, and that average waits for home care rehabilitation and re-ablement are now eight and six days respectively. And as money gets tighter, delays caused by waiting for decisions on NHS-funded continuing care are increasingly problematic.

The NAO’s conclusions on cost are particularly interesting: it estimates that the current cost of delays to the hospital sector is £820 million per annum, compared to a hypothetical cost of alternative community services for all those patients of just £180 million. Read more on the King's Fund website.

IAGG Busse Research Awards

To promote international research in gerontology, the Busse Research Awards again will be given at the 21th IAGG World Congress of Gerontology and Geriatrics in San Francisco, CA July 23-27, 2017. Two gerontologists (late junior to mid-career) will be selected. One award will recognize a scientist from the social/behavioral sciences; the other from the biomedical sciences. Awards are $8,000 (USD) each, plus up to $4,000 (USD) for travel/living expenses. Awardees must present a lecture based on their research at the conference. Deadline for receipt of nominations: November 1, 2016.

Download application instructions (pdf) and application form (pdf)

 

The National COPD Audit is moving to continuous, prospective data collection in February 2017

As of February 2017, the National COPD audit will be moving to continuous collection of clinical data, so aligning with other National Audits such as Stroke. Data will be entered via a new web-tool to enable real-time reporting, a process that has proved a key driver of Quality Improvement in in other National Audits such as stroke and myocardial infarction. A much-reduced COPD dataset will be used and a consultation on the content will be held soon. One or more of the indicators may form the basis of a COPD Best Practice Tariff expected to be introduced in 2017. Participation in the COPD Audit will be a requisite of Trust Quality Accounts and a cross-sectional spot audit of COPD care organisation and resourcing will also be undertaken later in 2017, one Section of which will be devoted to COPD Improvement plans made since the 2014 audit round.

The COPD Audit Programme is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) and continues to be led by the Royal College of Physicians, in association with the British Thoracic Society, the British Lung Foundation, the Royal College of General Practitioners, and the Primary Care Respiratory Society UK.

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Help develop research relevant to older people

BGS Blog: The National Institute for Health Research (NIHR) is now 10 years old! During the last decade it has contributed significantly to the health and wealth of the nation and is now the most comprehensive research system in the world. The Ageing Speciality Research Group is part of the Comprehensive Research Network funded by NIHR and has a remit to increase participation in research into ageing within the NHS. This means encouraging more clinical staff and older people to take part in more studies. The Ageing Speciality Group has representatives from each of the fifteen local research networks in England and from the networks in Scotland, Wales and Northern Ireland, as well as lay members to help provide the perspectives of service users and the general public. The local representatives come from a range of disciplines and are working hard to increase participation in research within their region. Read more

David Oliver: Delirium matters

BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i2886 (Published 24 May 2016) Cite this as: BMJ 2016;353:i2886

Delirium carries high mortality and morbidity and is a red flag for potentially serious illness. It’s characterised by acute onset over 1-2 days, a fluctuating course, and disturbances of cognition, perception, or consciousness. The symptoms of hyperactive delirium can be terrifying for patients—disorientation, restless distractibility, hallucinations, and paranoid misperceptions. Relatives visiting may be similarly distressed and bewildered at witnessing this (a patient’s story).

Meanwhile, hypoactive delirium—leaving patients stuporous and withdrawn, yet still distressed—is less dramatic and is more easily missed or misattributed to old age or dementia.

If a patient is not already delirious on admission, precipitants include infection, dehydration, metabolic disturbance, pain, constipation, urinary retention, surgery and anaesthetic,5 side effects from many drugs, and withdrawal from others.

Read the full article in the BMJ

NHS watchdogs abandon large-scale inspections as budget cuts bite

Telegraph: NHS watchdogs are to abandon large-scale comprehensive inspections of hospitals  in a bid to cope with a squeeze on funding, prompting alarm from patients' groups. 

The Care Quality Commission said hospitals would undergo a “more targeted” approach to inspection focused on the areas of greatest risk, with longer gaps between visits for services with the best ratings.

Three years ago, the watchdog promised a new strategy – including “bigger more expert inspection teams” - after it was widely discredited after becoming embroiled in an NHS cover-up over a maternity scandal in Morecambe Bay. But the new plan, in response to a 13 per cent cut in funding, will see a move away from “large-scale comprehensive inspections” unless there are particular grounds for concern. Under the systems, GP practices with a good rating could be left for up to five years without being checked. Hospitals will have a yearly check, but this can be limited to just one core service – such as surgery - and an assessment of the quality of leadership. 

NHS trusts will only undergo full inspections if there are already concerns about their quality, based on data from trusts and information from patients.

See also: Encouraging improvement and protecting people at a time of change: CQC launches new five year strategy (CQC); CQC pilots joined-up approach to health and social care inspection by place (National Health Executive)

We doctors can’t prescribe a ‘good death’

Guardian: Each new month seems to bring with it another well-intentioned report on death and end-of-life care. So far in 2016 we have had the End of Life Care Audit: Dying in Hospital from the Royal College of Physicians, a report from the British Medical Association (End-of-Life Care and Physician-Assisted Dying), and a review from the Care Quality Commission (A Different Ending: End of Life Care).

These various reports are marked by a kind of cloying earnestness, or “chronic niceness”, in the phrase of the hospital chaplain the Rev Peter Speck. On 9 May we had the Dying Matters Awareness Week. The number of government agencies and charities jostling for ownership of death is growing steadily.

Why has the NHS deficit ballooned? One word: understaffing

Guardian: Why are NHS finances in such a mess? The biggest reason is staffing – or, to be more precise, understaffing. The NHS in England is struggling with a serious and growing lack of personnel, especially nurses and some specialist doctors. This is forcing hospital trusts to spend unprecedented amounts of money on locums, especially those supplied by employment agencies, many of which charge what have been described by the NHS England chief executive, Simon Stevens, and the health secretary, Jeremy Hunt, as “rip-off” rates.

The sharp increase in the bill for agency staff mirrors almost exactly the dramatic decline in the health service’s finances. These personnel cost the NHS £2.5bn in 2013-14, rising to £3.3bn in 2014-15. The bill for 2015-16 was expected to hit £4bn, but new caps on trusts’ agency staff spending, introduced by Hunt last year, brought that down to £3.7bn – a saving of £300m, but still astronomical. There has also been a crackdown on the use of management consultants.

See also: NHS figures are bad, but the true underlying deficit may be even worse (Guardian)

People’s involvement in their care – new report

Care Management Matters: The Care Quality Commission (CQC) has published a new report exploring people’s involvement in their care. People’s right to being involved in their own care is enshrined in law in the fundamental standards of care. It is an essential part of person-centred care and leads to better and often more cost-effective outcomes. Better Care In My Hands is based on analysis of CQC’s national and thematic reports, such as State of Care, its inspection findings and on its NHS patient surveys. It sets out what enables people’s involvement in their own care and provides examples of good practice, as identified by CQC inspectors.

The reports key conclusions include:

  • As reported in recent national patient survey data, just over half of patients definitely felt involved in decisions about their health care and treatment.
  • Adults and young people with long terms physical and mental health conditions, people with a learning disability and people over 75 are less likely to be involved in their care than other groups – they report feeling less involved and other evidence demonstrates this.
  • Women who use maternity services are particularly positive about how well they are involved in decisions about their care.
  • There has been little change in people’s perceptions of how well they are involved in their health or social care over the last five years. A significant minority of people have consistently reported only feeling involved in their care to some extent or not at all over this period.
  • CQC has reported a lack of progress over the last six years in involving people in their care when they are detained under the Mental Health Act. Poor involvement in care is the biggest issue the regulator found in monitoring the use of the Mental Health Act in 2014/15.

BGS Special Medal - help us celebrate special people!

Our BGS Special Medal 2016 recognises a non-medical professional who has made an outstanding contribution to promoting the health and wellbeing of older people. We are now seeking nominations for worthy candidates from our partners in the not-for-profit and public sectors including charities, voluntary organisations and support agencies. 

The British Geriatrics Society is the professional membership association for doctors, nurses and other health professionals engaged in the specialist health care of older people across the UK. Each year we award a small number of prize medals to recognise the outstanding contribution of individuals towards better health in old age. One of these prizes, our BGS Special Medal, is an external award “for individuals whose work to promote the health and wellbeing of older people throughout society has been outstanding”. 

Criteria: The individual may be active in any relevant field, whether a charity, voluntary or self-help organisation, or local authority or NHS. Their outstanding contribution might be over a long or short period. The only firm criterion is that he or she must have made a major contribution and deserve recognition for their work to promote the health and wellbeing of older people throughout society. 

How to submit your nomination: The nomination process is fast and straightforward, simply email a paragraph or two explaining why you think your nominee’s work to promote the health and wellbeing of older people throughout society deserves recognition to the BGS's Chief Executive Officer, Colin Nee by email via  

Nominations are open now. The deadline for applications is Monday, 6 June 2016.

Brenda Stagg, Dementia Support Manager at the Alzheimer’s Society, was awarded the BGS Special Medal in 2015 in recognition of her work with older people in Liverpool. Brenda commented: "It was amazing and a wonderful surprise to receive the award from British Geriatrics Society for my work. To have the acknowledgement and recognition, both personally and for the Alzheimer's Society, meant a great deal to me. It was highlighted to the whole organisation and I received many kind words from colleagues congratulating me. I would highly recommend nominating a colleague or staff member for a BGS Special Medal; it is the perfect way to highlight and reward the work of an outstanding individual who is making a positive difference to the health and wellbeing of older people."

To read a full interview with Brenda Stagg CLICK HERE.

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