British Geriatrics Society

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Executive Summary

The British Geriatrics Society (BGS) is calling for the greater involvement of clinicians in the development of healthcare policy to ensure the design, commissioning and delivery of health services appropriate to the needs of older people.  The BGS manifesto calls on the next Government to implement policies which will: ensure older people have access to timely and effective healthcare; promote healthy ageing; lead to better integration of health and social care; and fund scientific research into ageing and age-related conditions. The manifesto’s key points are:

• Older people must have equal access to timely and effective healthcare, including a comprehensive assessment (which includes a full diagnostic work-up) and a treatment plan - regardless of their age.
• All health and social care workers should receive training on caring for and understanding the special needs of older people and how to provide dignified care.
• Frail older people and those suffering from dementia will benefit from specialist medical attention in hospital and community settings.
• Care home residents should have better access to healthcare services.  This includes a pre-admission comprehensive geriatric assessment and medication reviews.
• It is important to communicate healthy ageing messages to older age groups and to counter negative stereotypes of ageing.
• Vaccinations for older people are important as part of a prevention strategy.
• Health and social care should be more closely integrated in order to ensure better coordination and provision of care for older people.
• Scientific research into all aspects of ageing and age-related conditions is vital.  Older people should be included in clinical trials of medications and interventions.

Timely and Effective Healthcare For Older People

Older people must have equal access to timely and effective healthcare, including a comprehensive assessment (which includes a full diagnostic work-up) and a treatment plan - regardless of their age.

• Older people have a right to equal access to healthcare

The BGS opposes discrimination against older people (either direct or indirect) and believes that decisions about health and social care should always be based on clinical appropriateness and not made on the basis of chronological age alone.

Old age itself is not an adequate explanation or cause of physical or mental illness.  Although sensory impairment, vulnerability to and delayed recovery from illness may be features of advancing age, older people have a right to a correct diagnosis at the time of acute illness or loss of independence.

Older people also have a right to assessment and treatment by a team of appropriately trained and committed professionals when recovering from an acute illness or change in health, even when recovery has been, or is expected to be, limited.

• All health and social care professionals need training in the care of older people

There is a need to improve the training of all healthcare workers, as the majority will have regular contact with older people. All professionals should be aware of basic principles of dignified care which take account of the needs of older patients. Training curricula for doctors, nurses, therapists and other health and social service professionals should contain key elements on the needs of older people.

• Frail older people need specialist medical attention in hospital and community settings

Frail older people often have high morbidity rates, different patterns of disease presentation, a slower response to treatment and requirements for social support; these factors call for special medical skills.  Geriatricians provide high quality clinical care for frail older people as part of a multidisciplinary team during acute and chronic illness, rehabilitation and at the end of life, in both hospital and community settings.

It is important that individuals suffering from dementia receive timely and appropriate care.  The acute care workforce must receive adequate training to understand the specific needs of people with dementia



• Care home residents need better access to health care services
  Care home residents do not have access to the full range of healthcare services, to which other members of the community have access.  All care home residents should receive a comprehensive geriatric assessment before they enter a care home.  They should also have their medications proactively reviewed within 14 days of admission and at a minimum of 6-monthly intervals thereafter.

Care home workers need additional training and support in order to provide residents with high quality and dignified health care.

Promote Health Ageing

There are a range of effective preventative measures which can be undertaken to reduce the hospitalisation of older people, their deterioration and their need for long term care, thereby reducing healthcare costs.

• Communicate healthy ageing messages to older age groups – ‘Its never too late…’
  The need to communicate effectively with older age groups is very important.  There should be a public health focus on healthy ageing messages which emphasise that it is never too late to stop smoking, to exercise, to eat healthily, and to reduce alcohol consumption.
• Vaccinations
  Immunisations which protect the older age groups play an important part in the healthy ageing agenda.

Integration of Health and Social Care

Older people and their carers benefit from close coordination between primary and secondary care and social care teams.   As more people receive care in the community, it is essential that information is shared and that there are good links between all the professionals involved in an individual’s care.

There is evidence to suggest that geriatricians can reduce hospital admissions if they are involved in regular meetings with primary and social care teams who provide care for older people at home.  This enables the early detection of decline, usually in the context of increasing care needs in the home.  The geriatrician can intervene to provide and co-ordinate a timely comprehensive assessment by the inter-disciplinary team and treat underlying medical conditions (many of which are modifiable or reversible).  In the absence of such intervention, the individual's care needs can increase, and if managed entirely within a social care context, the individual may later present as a potentially avoidable emergency hospital admission.

Support Scientific Research Into Ageing and Age-Related Conditions

There is a need for adequately funded and well coordinated research into ageing and the needs of older people.  Better understanding of the biological, medical and psychosocial aspects of ageing is essential if, as a society, we are to narrow the gap between life expectancy and healthy life expectancy.   Such research also enables us to identify and develop new interventions and therapies for the common age-related diseases.

Trying to understand human ageing and minimise the detrimental effects of age-associated diseases on individuals requires investment, but the relative cost is insignificant when compared to the costs of age-related disease and the missed opportunities of failing to benefit from older people’s talents and potential.

• Older people should be included in clinical trials of medications and interventions
  The continuing under-representation of older people in clinical trials is a cause of major concern.  Despite their high levels of chronic disease and subsequently high drug use clinically, older people have in many cases been systematically excluded from the randomised controlled trials which are the basis for evaluating the safety and efficacy of newer treatments.

The BGS would be delighted to provide further information on any of the above topics. Please contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it or call 020 7608 1369.

See also  facts and figures relevant to ageing and health in the United Kingdom