The NSF, CHI and NICE reports, together with the HAS standards in Scotland, are all attempts to define standards of care for older people receiving health care.

The BGS Policy Committee was concerned that there has not been a definitive statement of how geriatricians should contribute towards improved services for older people especially, but not exclusively, when they are ill.

Over the past year the Policy Committee with the support of the Executive Committee, has worked to compile such a document, not to revisit old debates about styles of service delivery, but rather to define the expectations the BGS has for geriatricians and those who work with them in specialist departments. The standards have also been reviewed by Age Concern in order to ensure the proposals are in keeping with the expectations of older people themselves.

Standards of Care for Specialist Departments in Geriatric Medicine
The document is available to download on the website at www.bgs.org.uk. It is subdivided into sections which will link with the NSF, but is a statement of policy which applies to the whole United Kingdom, and is equally relevant in countries where the NSF does not apply. In many cases there is ample evidence to underpin the contents but for simplicity the references have been omitted. It is a statement of expectation which will help to set and develop standards and services locally, often in an incremental fashion.

In conjunction with any guidelines for care, there is a need to undertake local review of services to monitor quality. This is necessary as part of the clinical governance programme of any Trust and also as part of the clinical evidence needed by consultants as part of their appraisal. Aware of the shortcomings in older people’s services of the English National Performance Assessment Framework, the Policy Committee in this document has provided ideas to enable the development of local clinical performance indicators which, if supported by appropriate clinical information, could be used by BGS members to review local services. It is important to note however, that some of the suggested performance indicators are not absolute values, but rather allow continuous local review in order to signpost areas which may benefit from more detailed investigation and audit.

Copies of the document summary, together with the web site details for downloading will be sent to PCT’s and NHS Trusts for their information and in the hope that it will facilitate discussions about investment decisions and development of services, both now and in the future.

In line with all other compendium documents, ‘Standards of Care’ will be reviewed regularly by the Policy Committee - generally in a 3 year rolling cycle. Comments about this document, either concerning style or content, would be most welcome. Comments about the audit/performance indicators and their local utility would also be particularly useful in order to plan the structure of future compendium documents.

Gill Turner
Chair, Policy Committee