Over the last two years, the Policy Committee has been carrying out a detailed review of the BGS Compendium of Guidelines. These will be published on the BGS website over the coming months.

Over the years, the BGS has produced a large number of policy statements promoting higher standards of medical education, and care of the older patient. These were produced and publicised to the membership in slightly haphazard fashion until 1994, when the BGS Policy
Committee took control of the policy coming out of the Society. It was decided to review all
the publications produced by the Society over many years, to update them where necessary, and to bring them together in a compendium. It was a substantial piece of work, carried out under the able leadership over some years by Dr Alistair Main, Dr Clive Bowman and Dr Doug MacMahon.

By dint of serendipity, as the first compendium reached completion, the BGS was bequeathed a
sizeable sum of money by a member of the public, and with the approval of the executors of
the estate, the bequest was used to print 3,000 copies of the Compendium. These files were mailed to members of the BGS, but we also publicised their availability to every health authority in the country and received some 400 orders for copies of the file. The project did
much to raise the profile of the British Geriatrics Society and demand for the views and
recommendations of the Society on a range of issues has been high ever since.

With the advent of the Internet, Dr David Black, in his capacity as Honorary Secretary of the Society, commissioned the BGS Secretariat to develop the BGS website. The Compendium of Guidelines, Policy Statements and Statements of Good Practice formed the back bone of this project. Web statistics indicated that the compendium pages were the target of most visits to the fledgeling website. It was also surprising to find that among the visitors to the online compendium, there was a gratifyingly high number of overseas visitors. The Society experienced an unprecented growth in overseas members during this period. In particular, our membership from the Netherlands went from zero to nearly 50 members in just under a year. There was an increasing number of overseas delegates, both attending and participating in our scientific meetings.

Since that time, maintaining and updating this series of documents has
been one of the core responsibilities of the Policy Committee, but the speed of change in geriatric medicine has demanded a change in both the structure of the compendium, as well
as a timely review of all the documents which form this work. As a result many familiar documents have now been gracefully retired to be replaced by new guidance which we hope members will find interesting, and a valuable source of advice and information.

So how are things changing?
The new Compendium will see the documents re-organised into four sections. Section 1 will include short statements which crystallise the values and attitudes of the Society. Section 2 will comprise a series of clinical guidelines drafted by the Clinical Practice Evaluation Committee which apply to individual patients in the clinical setting. Section 3 relates particularly to the work of the Policy Committee in providing service guidelines which describe components of service, standards of care and guidance on general issues affecting the health care of older people. An additional Section 4 has recently been added to include position statements issued by the Society, and other resources such as survey data under the heading of reference material.

Future Challenges
One of the challenging aspects of producing and implementing policy results from the complexities arising out of devolution in the United Kingdom. With policy within the four nations becoming increasing divergent, it is nevertheless incumbent on the British Geriatrics Society in general, and the Policy Committee in particular, to provide cogent guidance on best practice in the management of the frail older patient. For example, whether a country officially acknowledges the term “intermediate care” or not, the Society needs to take cognisance of the countrywide practice of this form of care, whatever it is called, and to provide guidance on the best practice in intermediate care.

Next Steps
By the time you read this article, some of the new compendium will be available to view on the website and I hope you will all take a few minutes to take a look and let us know your views, either to me directly or via the Editor. There are several additional points to make. Firstly, apart from featuring each compendium document in the form of a summary in coming issues of the Newsletter, the full versions of the compendium documents will be available on the website only. In the interests of keeping costs down, and given the rate of change in policy, we do not have printed copies of the documents. Nevertheless, copies in Word format will be available for downloading.Secondly, some of the documents are still being reviewed and will only be added later this year. Please keep an eye open for changes over the next few months.

Acknowledgements
I wish to thank my predecessor, Gill Turner who devised the structure for the new compendium and did much of the work in bringing together this huge piece of work. I am also indebted to my colleagues on CPEC, the Education and Training Committee, various SIGs, and members of Policy Committee, past and present, including the BGS administrative team.

David Beaumont
Chair, BGS Policy Committee

Section 2-Clinical Guidelines
A particularly exciting feature of the new compendium will be an expanding section containing clinical guidelines for specific clinical situations. This will include the joint BGS/AGS Falls Guideline, the recently developed Pain guideline and soon, an updated guideline for management of delirium. About to be published, is a concise document on the management of depression in acquired brain injury, which will be added to this section at the time of the launch.

Section 3-Service Guidelines
This is the largest section and comprises over 20 documents. For ease of reference, these have been grouped into 6 subsections

Subsection 1: The speciality of Geriatric Medicine
This includes statements on the Aims and Functions of the Society, the Strategic review carried out by the President and Chief Executive, the Standards of Specialist Care document and a revised Rehabilitation of Older People statement.

Subsection 2: Ethics and Legal Issues
Included in this section is advice on such issues as Advance directives, Testamentary capacity, CPR decisions, Procedures for compulsory admission of patients with psychiatric illness, Nutritional advice in common clinical situations and Copying letters to patients (featured in this issue of the Newsletter - p25).

Subsection 3: Acute hospital based issues in health care of older people
Here, members will find updated guidance on Acute medical care for older people, Discharge planning and collaboration between geriatricians and psychiatrists of old age. The recent document concerning the older person in the accident and emergency department also appears here.

Subsection 4: Community Interface Issues in Health Care of Older People
This large subsection covers a wide range of topics including Health promotion, Intermediate care, the Role of the geriatrician in the community, and Assessment of older people for continuing care. The second half comprises documents on the Importance of vision in preventing falls, Palliative care, The care of older people in care homes and a recently revised and very topical statement on Abuse of older people.

Subsection 5: Training Section
The Education and Training committee has kindly undertaken development of this section which at the time of writing is almost complete. The finished version will have 5 documents outlining Curricula in geriatric medicine for undergraduates, postgraduates, old age psychiatry trainees, and also GP vocational trainees. The remaining section will be a recommended reading list for specialist registrars and other clinicians training in geriatric medicine

Subsection 6: Individual Service Specifications
Here members will find a small number of documents describing patterns of service for patients with Parkinson’s Disease and Limb fractures.

Section 4: Reference Material
Over the last year the Society has been asked to provide Evidence for the House of Lords and the House of Commons Health Committee on a variety of topics including the Assisted Dying Bill, Research, and the Public Health White Paper, “Choosing Health”. In addition, the National Councils and other groups within the Society produce survey data, for example the English Councils consultant and reimbursement surveys. It was felt it would be useful if these position statements and data that support policy statements could be available for members to consult, so this additional section has been added to accommodate these statements.