Message from Dr Martin Vernon, National Clinical Director for Older People: The new GP contract for 2017/18 was announced on Tuesday (see report below). It withdraws the avoiding unplanned admissions enhanced service and aims to ‘put a mainstream focus’ on older people living with frailty through a requirement for routine frailty identification for people aged 65 and over using a validated tool (for example, the electronic Frailty Index) to proactively identify and support older people living with frailty. For people with severe frailty (around 3% of over 65s) this will include a clinical review (medicines review, falls assessment and other clinically relevant interventions) and encouraging use of the additional information in the summary care record to promote safe, joined up care across different settings. We hope you agree this is a step forward in the journey towards more proactive, person-centred care for older people living with frailty.
Our next step is developing the guidance that helps practices introduce the contractual requirements smoothly, as well supporting those practices that want to go further to take greater advantage of the opportunity that routine frailty identification offers for improved prevention and better care.
We would value your continued support and guidance to help inform this and, in the meantime, if you have any queries or would like any further information please contact
The following files are secured pdf versions of the powerpoint files supporting presentations delivered at the the BGS Movement Disorders Meeting in 2017. These are published with the presenters' permission and the onus for assuring that copyright permissions are adhered to is vested in the individual presenters. They will remain on the BGS website under Resources/Powerpoint Library for two years:
A L Cunnington: National Parkinson's Audit 2015 and beyond
Helen Mann: Driving and Mobility
Biju Mohamed: New Treatments in Parkinsons
Claire Morris: The end of life in PD and the Parkinson's plus syndromes
Richard Walker: Parkinson's disease NICE guidelines 2017
HSJ (9 February): Four years after his report into the Mid Staffordshire scandal was published, Sir Robert Francis sets out his reflections on reforms carried out since 2013 and highlighted areas where he believes further work is still needed to safeguard patient safety.
This includes taking individual cases of poor care more seriously, a re-examination of the regulation of managers, the system of professional regulation, and the NHS complaints system, which he said was failing “from top to bottom”.
He also criticised the “diminution of the nursing voice” saying he believed “nursing and patients were being badly served” by the chief nurse being based with NHS England, and the Royal College of Nursing retaining its trade union role.
Read more on Sir Robert's reflections here.
See also: Francis: NHS pressures make another Mid Staffs 'inevitable' and NHS is facing 'existential crisis', Robert Francis warns
7 Feb 2017: An agreement has been reached with the General Practice Council (GPC) on changes to the GMS contract for 2017/18 which seeks to address concerns of the profession in relation to workload and increasing expenses and other agreed changes. The agreement also reflects commitments made as part of the General Practice Forward View (GPFV) and continues to make significant investment in primary care. The agreement has been approved across Government.
Particularly relevant to older people's primary care is advice from Dr Martin Vernon that the Electronic Fraily Index (eFI) and routine frailty identification (severe/moderate) is now in the GP core contract.
For more detail of the contract, see the NHS England website.
See also: HSJ commentary; and letter to Directors of Commissioning from NHS England Medical directorate
Published by the Nuffield Trust (8 Feb 2017): Nigel Edwards explores what the data tells us about delayed transfers of care and busts some myths about how to prevent them.
The NHS is under significant pressure this winter. The new year saw daily newspaper headlines on the winter crisis, while high rates of bed occupancy and cuts to social care are both causing extra pressures to build up across the NHS.
Underlying all of this is the growing number of patients who are ready to leave hospital but can’t do so without extra support. Delayed transfers of care (DTOCs), often (rather insultingly) called ‘bed-blocking’ by the media, have been steadily on the rise in recent years, with the numbers of days patients are delayed reaching record levels month after month.
TOCs are a complex issue and to fixate on one solution would be to miss the point. Here, Nigel Edwards explores what the data tells us about delays, and outline what can be done to address the problem.
Read more in the Nuffield Trust report
See also the National Audit Office's commentary on integration of health and social care
The Stroke Association is now inviting applications for its 2017 Priority Programme Award in Haemorrhagic Stroke.
The award amount is up to £450,000 for a period of 3 to 5 years. Deadline for expression of interest forms is 5 p.m. on 1 March 2017.
After this date, we will email prospective applicants with the full application forms for completion by 1st June 2017.
Click here for more detail
Reported in The International Business Times (2 February 2017): A cross-party campaign calling for an NHS and Care Convention got its "foot in the door" when the group of MPs held talks with Theresa May in the House of Commons on Wednesday (1 February).
Liberal Democrat Norman Lamb, a former care minister, told IBTimes UK that the discussion with the prime minister and Health Secretary Jeremy Hunt was "very constructive". Mr Lamb was joined by two senior Labour MPs, Meg Hillier and Frank Field, and three top Conservatives, Hugo Swire, Sarah Wollaston and Dan Poulter.
The group want to establish the NHS and Care Convention to find a long-term solution to the "crisis" in health and social care funding. "It was very constructive and I'm pleased that the prime minister agreed to speak to us," Mr Lamb said.
"They took us seriously, they took the case we made seriously and we asked if [Mrs May] was willing to initiate a dialogue to explore this idea further, rather than slamming the door on us, and she did that."
Reported in The Guardian (2 February 2017): The Royal college says decline – part of drop in English applications across university courses – raise fears for future recruitment.
Applications by students in England to nursing and midwifery courses at British universities have fallen by 23% after the government abolished NHS bursaries, figures show. Nursing leaders said the sudden slump revealed by the latest university application data was inevitable given that student nurses now faced paying annual tuition fees of more than £9,000.
“These figures confirm our worst fears. The nursing workforce is in crisis and if fewer nurses graduate in 2020 it will exacerbate what is already an unsustainable situation,” said Janet Davies, the general secretary of the Royal College of Nursing.
“The outlook is bleak: fewer EU nurses are coming to work in the UK following the Brexit vote, and by 2020 nearly half the workforce will be eligible for retirement. With 24,000 nursing vacancies in the UK, the government needs to take immediate action to encourage more applicants by reinstating student funding and investing in student education. The future of nursing, and the NHS, is in jeopardy.”
Reported in The Times (2 Feb 2017): An innovative Dutch nursing home creates a world near to normality for residents. Comparisons to The Truman Show do not go down well in the Netherlands’s most innovative nursing home. “I understand why people say that,” Eloy van Hal says. “But they forget this is real — everything here is real.” Indeed it is real. The barman in our trendy restaurant is real, even if he is trained both in making cocktails and in dealing with severe dementia. The middle-aged woman whose order he is taking is really here for lunch, even if she is also a doctor. The elderly woman with dementia taking her family out for dinner at the next table will, after she has finished, walk down a real street to a real house — that has all the nursing equipment hidden in the living room cupboard.
See also: Poor service will get worse, warns Alzheimer’s charity (Times)
For Specialist Trainees sitting the SCE examination, we make available the mock exams and answer sets from the BGS Trainees' weekends. The 2017 mock exam questions and answers are not available.
2017 Exam (Trainees' Weekend, Cardiff