British Geriatrics Society

Most people in England receive a good quality of care. Our ratings show that quality overall has been largely maintained from last year, and in some cases improved, despite the continuing challenges that providers face. Some services have improved due to the focus and hard work of care staf and their leadership teams. Others have declined in quality as providers have struggled with the challenges they face.

Responding to the RCGP's consultation on a future vision for general practice, the Society recommends, based on our experience and expertise in working with older people, that there are some significant changes to general practice that would result in better health outcomes for all older people, whether they are living with mild, moderate or severe frailty, or are staying relatively healthy and ageing well. 

An increased focus on the prevention of deterioration and the optimisation of independence is needed for people living with multiple long-term conditions.  Identifying frailty at an early stage and providing earlier interventions for those people at greatest risk of developing frailty is central to this.  Stratifying frailty using frailty identification tools such as the electronic frailty index (e-FI) for patients aged 60 and above, and those people most at risk of adverse events, including hospitalisation, nursing home admission and death should be fully embedded in the service provided by general practice.  BGS warmly welcomed the introduction in 2017 of the routine frailty identification requirements for GPs.  However, the use of e-FI requires clinical correlation and the risk that false positives and negatives will sometimes arise from use of a statistical tool must be considered and addressed as part of the frailty identification process. 

Based at the University of Zurich and in collaboration with researchers from Germany, the Netherlands and the United States, we developed two short Fact Box decision support tools on antibiotics for pneumonia and artificial hydration in advanced dementia.