The BGS and the BOA share more than their patron - HRH The Prince of Wales. Members of both organisations provide care for some of the most complex and vulnerable members of our older population.

As the evidence base for falls and fracture prevention grows, so we are starting to see the evolution of a new and long overdue relationship between the British Geriatrics Society and the British Orthopaedic Association. The seeds of this partnership were sown at the BOA scientific meeting in September of last year when Colin Currie, Roger Francis and myself were invited to speak at a seminar dedicated to the care of hip fracture patients and coincided with the release of the orthopaedic “Blue Book” – The Care of Fragility Fracture Patients. This was swiftly followed by a highly successful return match with Dave Marsh, Professor of Orthopaedics at Queens University, Belfast, participating in 2 sessions (and a few glasses of fermented grape juice) at our Spring BGS in Derry.

Since then, things have moved on at considerable pace with a variety of joint ventures underway, all with the primary aim of enhancing the care of older patients with fragility fractures. It is anticipated this will be achieved through a variety of mechanisms whereby the joint forces of the two societies can facilitate change nationally in the political, clinical, educational and academic arenas.

Audit
The BOA, BGS and the RCP (Jonathan Potter/ Mike Pearson) have already entered into dialogue with respect to the development of a national hip audit and registry. As many will be aware, the Scots, through their intercollegiate guidelines network (SIGN) and the dedication of Colin Currie and others, are well ahead of the game in terms of having a national hip audit and register. Using the existing skills and expertise of the RCP Clinical Effectiveness and Evaluation Unit, there are plans to develop an audit tool for hip fracture which also incorporates standards for assessment of falls risk and bone health. Needless to say, audit as a stand alone tool, will not necessarily lead to improved care, but in keeping with the previous College audits on myocardial infarction and stroke, it is hoped that audit will highlight deficits in care and allow for the effective and efficient targeting of resources.

Joint Conference
The BOA and the BGS are working together to promote a systematic evidence-based approach to the care of older people who sustain a fragility fracture. Our first joint conference will be a multi-disciplinary meeting reviewing the state of the art in tackling the number one threat to musculoskeletal health and quality of life. Speakers from the BGS include Marion McMurdo, Roger Francis, Cameron Swift, Antony Johansen and Jacqui Close in what promises to be a truly multidisciplinary and interprofessional meeting.

The future
As this new relationship develops, it is hoped that new opportunities will arise for both societies to work closer together. Areas for future development include a joint research agenda, health service evaluation / implementation and a combined approach to the training of our future consultants in orthopaedic surgery and geriatric medicine.

There is little doubt that the BOA and the BGS are committed to working together with the open and visible support of the president/presidents elect (David Jones and Jerry Playfer) and chief executives (David Adams and Alex Mair) of both organisations actively participating and supporting this venture. One can feel reasonably optimistic that over time this will translate into first class care for older people who fall and are unfortunate enough to sustain a fracture.

Jacqui Close
Consultant Physician
King’s College, London