Geriatric medicine (geriatrics) "is that branch of general medicine concerned with the clinical, preventive, remedial and social aspects of illness of older people. Their high morbidity rates, different patterns of disease presentation, slower response to treatment and requirements for social support, call for special medical skills". The purpose is to restore an ill and disabled person to a level of maximum ability and, wherever possible, return the person to an independent life at home.

The British Geriatrics Society (BGS) was founded in 1947 for "the relief of suffering and distress amongst the aged and infirm by the improvement of standards of medical care for such persons, the holding of meetings and the publication and distribution of the results of research".

The Society is a professional association of physicians, paramedical staff and scientists. It is the only society offering specialist medical expertise in the whole range of health care needs of older people, from acute hospital care to high quality long-term care in the community. It now has over 2,000 members worldwide.

CURRENT AIMS
New legislation, government directives and developments in the health care field have changed quite rapidly in recent years. In order to keep its commentary on current aims up-to-date, the Society is placing details on this website (www.bgs.org.uk) in preference to printing them in the good practice guide.

THE SOCIETY SERVES:
The Older Person
Older people receive high quality medical care provided by members and through the activities described above.

Carers
People caring for an older person need guidance, support and information to help them cope with the physical, emotional and financial demands of looking after a frail dependant relative

Charities
Voluntary bodies that work with older people need authoritative information on the medical aspects of caring for older people

Professionals
People who work with or care for older people, e.g. other doctors, nurses, and health visitors, need information on a wide range of specialist issues concerning the health and care of the older person

Members of the Society
The Society organises national conferences twice a year as well as regional meetings for the exchange and dissemination of the latest information on research, advances in medicine for and care of older people.

A bi-monthly 28-page newsletter covers current affairs and reports on activity in the Society.
Members also receive the Society's bi-monthly scientific journal, Age & Ageing.

THE NEED
There are already 6.7 million people over the age of 70 of which 1.1 million are over 85. By the year 2036 there will be 10.8 million over 70, of which 2.2 million will be over 85. (Source: Population Projections by the Government Actuary 1994 Based Projection.) The risk of frailty and dependency is greatest in the very old; it is the increasing numbers of people living beyond 85 with whom the Society will be most concerned.

ADDING LIFE TO YEARS - A MEASURE OF SUCCESS
The UK has been in the forefront of geriatric medicine, resulting in the lowest international percentage of older people in institutional care (5% of those over 65). It is essential that the quality of health care is sustained and developed, to ensure that, wherever possible, older people live healthy independent lives. The change in policy, whereby the long-term care of older people is being transferred out of hospitals to diverse community resources, has made the provision of specialist care more difficult, but the Society is striving to ensure that, wherever care is delivered, the quality and the standards are maintained at a high level.

CAMPAIGNING FOR A BETTER DEAL FOR OLDER PEOPLE
Increasingly, concerned that older people were not well served by the health care system - in respect of access to appropriate diagnostic and treatment facilities, transition across the hospital/NHS and Social Services divide, and particularly in respect of assessment and rehabilitation prior to long-term care - the Society has, in recent years, become increasingly active in campaigning for substantial improvement in the system, with submissions to Ministers, news updates and presentations to MPs, and through collaboration with allied, age-related charities.

PROFESSIONAL EDUCATION AND TRAINING
To promote medical education and training the Society operates a number of schemes.

Medical Students Elective & Vacation Projects Grant
This grant is designed to encourage medical students to develop an early interest in the health and care of older people. It provides undergraduates with an opportunity to broaden their perception of experience of this growing field by undertaking, under supervision, a study of a relevant initiative in age research or the provision of health care, complementary to their taught curriculum.

The Amulree Essay Prize for Medical Students
Since 1986, the Society has encouraged undergraduates to take an early interest in medicine for older people and, to this end, the Society promotes an annual essay prize on any subject pertinent to ageing from a medical, biological or sociological aspect. The Amulree Prize is now fiercely contested, with many entries every year, each of a high standard.

Young Doctors Educational Grants
The Society offers a number of grants, originated through a bequest from the estate of Mrs Esther Hepher (a member of the public), to junior doctors to finance their attendance at BGS Scientific Meetings. Assistance may be provided if the health authority is unable to provide financial support.

Nurses Study Grants
The Society offers a number of grants to trained nurses (and nurses in training), with an expressed special interest in the care of older patients, to attend conferences, seminars and meetings of an innovative nature, which will enhance their understanding and appreciation of the special needs of older patients, and/or to visit a geriatric unit which has an innovative service approach or special programme or project for the care of older patients.

Therapists Study Grants
Grants have been made available, since April 1994, to qualified physiotherapists, speech and language therapists and occupational therapists (as well as therapists in training), with an expressed special interest in older patients, to attend conferences, seminars and meetings to enhance their skills in treating older patients, and/or to visit a specialised unit with a programme or project in the care of older people.

RESEARCH PROMOTION

Dhole Bequest
Thanks to the generous bequest of the late Dr M K Dhole, a former member of the Society, an amount of not less than £10,000 is provided annually to support a wide range of research projects in the field of geriatric medicine.

Specialist Registrar Research Start Up and Travel Grant
The Research Start-Up Grant programme provides immediate financial assistance to support research projects which may not yet be developed sufficiently to warrant support from research councils. It aims to give to young doctors financial help not already available from other sources. The scheme provides grants to enable them to follow through ideas at relatively short notice, to enable advantage to be taken of unique or rare opportunities, or to provide speculative and innovative research that may be at an early stage.

IMPROVING KNOWLEDGE, STANDARDS AND DELIVERY OF CARE - CONVERTING THEORY INTO PRACTICE; THE ACHIEVEMENTS OF THE SOCIETY

Grants to research and training
Since 1981, the Society has provided grants in excess of £500,000; the amounts and range of the grants having constantly expanded so that they now provide for a number of core research and exploratory projects, whilst other grants go to supporting medical training, undergraduate medical and paramedical training schemes, in addition to funding a range of essay and other prizes to encourage interest in geriatric medicine. The Society is currently developing a policy to focus national research in geriatric medicine into those areas which have so far been neglected.

Combating abuse
The Society convened, in 1988, the first ever conference on the abuse of older people, attended by 400 professional staff; it subsequently published a report of which thousands of copies were distributed, and was a co-author of the first guidelines for professional and lay carers. In 1990, through the work of its members, the legal precedent was established that neglect and abuse of older people is a criminal offence. The case for highlighting and combating abuse has now been taken over by a specialist charity Action for Elder Abuse, formed specifically for this.

National conferences to promote quality care
The Society has, in conjunction with other medical institutions, run a number of well attended national conferences to promote quality care in, for example: 1989, A Caring Home - improving quality and standards of care in homes and hospitals for the elderly; 1991, Long Term Care of the Elderly; 1994, Achieving High Quality Long Term Care for Elderly People; 1995, Better Contracting for Health Services for Elderly People; and 1999, The Teaching Care Home. The latter was held to explore the scope for training medical/paramedical staff outside hospitals now that long-term care is largely outside the NHS, resulting in staff being unable to gain experience in this important sector of care.

Scientific meetings
The physicians attending the Society's internal scientific meetings, held twice yearly, have doubled to around 600 in the five years leading up to 1999, reflecting the value of the meetings as a forum for members to present and discuss their research, coupled with the high quality of lectures given by UK and world experts in their respective fields of medicine, as part of the Society's continuing medical education and professional programme.

Publications
The Society has, over the years, produced a number of publications, starting in 1987 with the co-sponsored 48-page document, "Improving care of elderly people in hospitals", the 1992 document on elder abuse, a range of fact sheets on common disorders, and the proceedings of several conferences, the last, in 1999, being on the Teaching Care Home.

Professional advice
The Society has, for many years, offered specialist advice in response to a wide range of consultation papers and inquiries, covering, for example, clinical performance, health care structures, food safety, and legal and ethical issues. Notably, the Society has responded to the many Green Papers on health provision, submitted evidence to several House of Commons Health Committee Inquiries, in 1998, to the Royal Commission on Funding Long Term Care, and, in 2000, to the Department of Health on the findings of the National Beds Inquiry, as well as giving scientific advice to the National Institute for Clinical Excellence (NICE).

In 2004 and 2005, the Society was consulted on:

• The "Assisted Dying for the Terminally Ill Bill". Written and oral evidence submitted to the House of Lords - Aug and Dec 2004
• "Scientific Aspects of Ageing". Written and oral evidence to the Science and Technology Committee of the House of Lords - Sep-Oct 2004
• "Draft Mental Health Act and draft Mental Capacity Act". Written statement to the pre-legislative scrutiny committee of the House of Commons - Oct 2004.
• "The use of new medical technologies within the NHS". Written submission to the House of Commons Health Committee - Jan 2005
• "The Government's Public Health White Paper". Written submission to the House of Commons Health Committee - Jan 2005
• "NHS Continuing Care" Feb 2005

The Special Interest Groups
Many geriatricians have, in addition to the broad spectrum of expertise in general internal medicine in older patients, chosen to research specific clinical and management areas.

In addition to the Drugs & Prescribing Section, founded in 1989, there are now 11 additional Groups (SIGs)/Sections, namely, Cardiovascular, Primary and Continuing Care (including a focus on rehabilitation and management of chronic conditions), Cerebral Ageing & Mental Health, Diabetes, Falls & Bones Health, Gastroenterology & Clinical Nutrition, Health Services Research, Medical Ethics, New Technology in caring for older people, Parkinson's Disease, and Respiratory.

Each Group either holds its own bi-annual or annual scientific meetings or provides parallel sessions at the Society's national meetings. In addition, the Groups respond to government consultation documents, and publish guidelines and policy statements.

For example:

• the Diabetes Group has produced guidelines on how to manage older diabetics, entitled 'Unified Clinical Guidelines for the Management of Diabetes';
• the Drugs & Prescribing Section has run national training sessions on clinical pharmacology for junior doctors, and offered advice to NICE;
• the Gastroenterology & Nutrition Group has held a popular symposium on under-nutrition in acute illness;
• the Care-Home Medicine Group ran a workshop to promote multidisciplinary assessment;
• the Medical Ethics Group has offered advice to the Lord Chancellor's Department on legislation covering mental incapacity;
• the Parkinson's Disease Group has held national conferences on adapting science to practice in treating Motor Disability and on Movement Disorders;and
• the Health Promotion Group and Respiratory Section have run successful parallel sessions at the Society's scientific meetings.

The presence of the Special Interest Groups, which include physicians, scientists and other professions allied to medicine from outside the Society, has enabled the Society to offer advice to government agencies drawing on a wider range of expertise. The SIGs serve as the Society's source of clinical innovation, deriving and maintaining high standards of clinical care, and dissemination of specialist knowledge.

MANAGEMENT AND STANDING COMMITTEES

Management
In 2003, the British Geriatrics Society amended its constitution to recognise the devolved structure of government in the United Kingdom. Northern Ireland has had a devolved administration with its own Ministry of Health since 1921; Scotland has also had a considerable amount of autonomy with respect to health matters for some years; and Wales is developing an increasing number of its own policies.

Geriatric medicine is a specialty closely related to administration of both health and social services and, as it seems likely that policies in the four nations are increasingly going to diverge, the Society has taken account of this by forming National Councils for England, Northern Ireland, Scotland and Wales. On a UK-wide level, the activities of the Society are managed by the UK Management Council, consisting of representatives from each of the national councils, the Chairmen of the standing committees, and office bearers.

The Policy Committee serves as the Society's powerhouse on service management and has masterminded the on-going production and update of the Good Practice Guide of Guidelines to cover, for example, · the provision of services by departments of geriatric medicine; the role of the geriatrician in the community; collaboration between geriatricians and psychiatrists; resuscitation policies; rehabilitation; and artificial feeding.

The Academic and Research Committee oversees the running of the Society's national spring and autumn scientific meetings, with attendances of over 600 delegates. The programmes include clinical updates, oral and poster research presentations, guest lectures of national and international repute, and satellite symposia. The committee also acts as a coordinating point for the Special Interest Groups and provides support to academic departments of medicine and their research.

The Education & Training Committee works with the Specialist Advisory Committee of the Royal College and plays a significant role in preparing the training of Specialist Registrars and in monitoring manpower.