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Editorial

 

So the BGS has turned 70, and we have been celebrating the great strides made in the care of older people since its birth. Apart from the national celebrations, attended by our Patron, the Prince of Wales, the various national offices of the BGS have held their own events to mark the anniversary.

As we grow, it is especially important that our history is documented and we are fortunate to see many contributions to this work. In particular, we have Dr Michael Denham, (BGS president 1992 - 1994) who provides valuable and dedicated service, charting the sociological trends in which the great philanthropists were forged, leading to the birth of the National Health Service and of geriatric medicine in the United Kingdom.

Geriatric medicine having at its centre, the whole person, as opposed to a single organ, has all the breadth and scope of general medicine. We have at times therefore struggled to focus on any single digestible message.

This changed in more recent years as we moved from emphasising the need to treat older patients with dignity (Dignity Campaigns of 2010 and 2011), to the merits of performing comprehensive geriatric assessments, (CGA), to our focus on frailty (2015 - 2016) and more recently, to the importance of physical activity.

So this year, we take up the challenge of living well for as long as possible, being aware of the de-conditioning phenomenon in older people (or indeed, in anybody) who becomes bed- or hospital-bound for any length of time, and the simple steps we can take to combat it.

Under the leadership of Dr Amit Arora, the University Hospital of North Midlands (UHNM) embarked on the ‘Sit up, get dressed, keep moving’ campaign. This has since been endorsed by the British Geriatrics Society and, courtesy of the UHNM, we will be making the tools available to raise awareness of deconditioning.

Amit’s work reached national prominence, having been examined by David Mitchell in the pages of the Guardian. Despite some prodding from Mr Mitchell about how it was all just a cynical money-saving exercise for the NHS, Amit responded honourably with a passionate defence of this very successful grass roots campaign.

Closely related to the basic issue of ‘de-conditioning’ is that of ‘inactivity’, one of the scourges of modern society. In our lead article, Muir Gray notes that the BGS has provided leadership which has effected significant culture change on several fronts, but he cautions that we need to lead a new cultural revolution, to emphasise that people of any age and with any number of conditions can become fitter and that increased fitness can prevent or delay the onset of the need for social care.

As I write, the election looms and we have just signed off on our seven-point manifesto (see Caroline’s policy updates). Social care is, of course, a major focus of this document, which was sent to all political parties. A call for a lasting solution to the current crisis is one of our core messages, as well as integration of health and social care, greater capacity in intermediate care and access to CGA for older people with frailty, dementia and multimorbidity. We continue to have a strong policy voice, and will try to meet with the incoming government team to ensure we are in a position to influence the future direction.

Of course, CGA is one of the great successes of the past 70 years and this was marked by a dedicated session at the Spring Meeting in Newcastle. Simon Conroy and Stuart Parker chaired a session where they examined how CGA is now developing, including in other care settings such as emergency department, perioperative setting and oncology. The meeting also featured very well attended sessions on ethics and law where Des O’Neill and others led a stimulating discussion. Our meeting report takes in the highlights.

On the shoulders of great men
Returning to the subject of our history, it is with sadness that we report the passing of yet more of geriatric medicine’s pioneers of the last century. Professor Robert Kane, Professor Gwyn Seymour and Dr Wallace Dickie were three of the greats of our specialty and as geriatric medicine (and the BGS) forge into the future, we continue to be conscious of the dedicated people who battled against the prejudices mentioned in Muir Gray’s article, to make geriatric medicine the popular and respected specialty that it is today. 

Shane O’Hanlon

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