BGS Wales Update - August 2018

15 August 2018

The following report was delivered at the July meeting of the BGS Board of Trustees: 

Formal links with Welsh Assembly Government 

A National Speciality Advisory Group (NSAG) was set up around five years ago for each speciality to report to government.  How useful and productive this has been is hard to determine but we will persist with this group. The current chairperson rotates into this role. 

Regional Meetings 

BGS Wales has held two regional meetings each year, alternating between north and south. The last meeting in North Wales was well attended. The next meeting is in Cardiff. Meetings last for one and a half days and provide a forum for good educational, professional and social networking. 

The national BGS meeting in Cardiff (again) in Spring 2019 is high on our agenda and likely to be well attended by Welsh colleagues. 

Workforce Issues

There are 88 Consultant geriatrician (stroke) posts in Wales. Most HBs have unfilled posts. 

There are 45 whole time trainees (registrars) in geriatric medicine in Wales. Seven mature every year and the majority remain in Wales. Absolute number of vacant posts is small but due to a fairly low denominator, there can appear to be large percentage of absence in posts (especially North Wales). 

Wales needs to fill 10 -15 posts per year 

Key problems facing older people in Wales 

A service reconfiguration is occurring in Stroke nationally and at HB level for several HBs - predominantly to a hub and spoke based model. The stroke reconfiguration has not moved on substantially since the last report.  Like all UK stroke services, thrombectomy will be challenging but there is central government acknowledgment of its importance.

There is central government interest in PROMS and PREMs, this is beginning roll out, especially in Welsh stroke care.

There is a lack of capacity for frail older people including people with dementia. There are various reasons for this (delays in providing community services, myth that older people do not need assessments in hospitals, reduction in care home beds etc.) The continued divide between health and social care also remains an issue.

There is a growing interest in frailty across speciality and with some higher level engagement. There are some national moves to implement a comprehensive and Wales wide frailty scale, most likely the seven point CFS.

Demographic facts

Wales has a population of around 3.15 million (as opposed to 53 million in England, 5.3 million in Scotland and 2 million in Northern Ireland).  8.6 per cent are above the age of 75, 2.5 per cent are aged over 85.

There are seven health boards in Wales (replacing the 22 LHBs).

There are two medical schools located in Cardiff and Swansea.

Jonathan Hewitt
Chair, BGS Wales