As you read in the September issue of the Newsletter, the BGS has established an NSF Focus Group as part of the Interim Administration for England.

With my background of postgraduate deanery, membership of the BGS Training Committee, and dealing with training across Europe, I was asked if I would hold a watching brief on the training and workforce issues that came up as a consequence of the National Service Framework. I see this as covering all aspects of training, not just of specialists, but of primary care nurses and other health professionals as well. I want to make it very clear however, that I have no intention of stepping on the toes of the BGS Training Committee, nor of Alistair Main in his role as BGS Workforce Committee chairman.

At the present time I believe there to be three areas for consideration:

More training slots with NTNs
Alistair’s article in the September Newsletter very succinctly explains the issues around increasing NTN numbers. By the time this article is published we should know whether the postgraduate deaneries have been successful, firstly in gaining the extra ceiling NTNs, and secondly whether they have managed to get any numbers additional to these. In this round of bidding I am sure that the number of NTNs that we receive, whatever that may be, will be less than the number of bids that have come in from the individual Trusts who have been able to find the finance for these potential extra posts. The postgraduate deaneries, along with the Workforce Development Confederations, will therefore be looking very carefully at which posts will be able to provide the best training, whilst taking into account geographical divisions. It is hoped that another bidding round will occur next year.

Intermediate care
This is probably the most talked about aspect of the NSF. Those consultants who trained ten or more years ago followed, in general, a training programme containing those aspects of geriatric medicine that would now encompass intermediate care. With a shift over the last decade to geriatric services becoming more involved with acute medicine, some of these aspects have not been so well covered within our training programmes. The BGS Training Committee has identified this and, under the chairmanship of Steve Allen, is producing a curriculum appropriate to a consultant taking an interest in intermediate care. It is hoped that the SAC will take this on board.

Workforce Development Confederations
These have been fully operational since April 2002. They have a responsibility for making sure that the local workforce is fit for the purpose for which it is required. This includes not only nurses and therapists, as was previously the case with the old educational consortia, but now in association with the postgraduate deans, also the medical workforce. Your Workforce Development Confederation will be looking at the NSF and local HImPs in order to decide the training requirements for the local workforce. It is important that local groups, including geriatricians, looking at the NSF for Older People, be in close contact with the Workforce Development Confederations in order to make sure that we have a properly trained workforce for the future of older people.

Many people have said that we live in interesting times; that is true. Others say we live in a time of change; that is also true. With both of these running concurrently, it is imperative that as geriatricians we do not take our eye off the ball, because if we do we will suddenly find that we have been left out in the cold, not doing what we have been trained for. Also it would not be fun, and we should be enjoying ourselves!

Ian Hastie
Interim Administration Member