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I do not like to start with ominous news but there are two storm clouds on the horizon - the possible winter influenza pandemic and the economic downturn.

I mentioned the financial threats in the last Newsletter - the UKMC (the BGS’s “cabinet”) will be discussing how we can minimise damage to services for old people and hopefully find positive ways of providing high quality care in the lean times ahead.

The Department of Health and the RCP London have done much useful preparatory work and I commend their websites to you. One practical innovation is giving cards to those with chronic conditions: yellow cards for those likely to need a follow-up appointment during a pandemic, and blue cards for those who require remote access but not an appointment at such a time. Please see the RCPL website and do what you can to produce and distribute these cards in your locality.

Clinical Excellence Awards
Geriatric medicine attracts some of the brightest and best doctors, most of whom work hard to ensure that patients and families receive the highest possible standards of care. Geriatricians are innovators who are flexible in their delivery of services - perhaps this partially explains why no two Geriatric units in the world are quite the same.

The clinical excellence awards system recognises and rewards those consultants who go the extra mile and who make important contributions to clinical services, teaching and research and other aspects of medicine. One would imagine that we were identified by the Advisory Committee on Clinical Excellence Awards (Scotland and Northern Ireland have a similar system) as doing meritorious work. The suspicion that we are not doing as well as many colleagues in other specialties has been confirmed in a reply I recently received from the head of the England and Wales awards policy group.

Our success rate in getting Bronze and Silver awards is lower than Cardiology, Dermatology, Endocrinology/Diabetes and Gastroenterology. Why is this?

There seem to be three main problems. First, fewer Geriatricians are applying for fewer awards compared to those in other disciplines. For example, only 32 per 1000 Geriatricians applied for a Bronze award last year, compared with 42/1000 in Oncology, 47 in Rehabilitation Medicine, 48 in Rheumatology and 51 in Renal Medicine. The figures for Silver awards are even more striking: 52/1000 applicants in Geriatrics against 108 in Oncology, 116 in Renal and 165 in Infectious diseases. We did much better for Gold applications, but not nearly as well as Palliative Medicine, Oncology and Renal Medicine.

Secondly, those who do apply are not carefully following the guidance for applicants, thus reducing their chances of success. Poor spelling and grammar do not enhance one’s chances of success. Some submissions are poorly constructed and seem to have been written in a hurry. Thirdly, geriatricians tend not to demonstrate excellence by benchmarking their activities with others in their specialty/sub-specialty: Those who do this have higher chances of success.

The BGS is considering other ways of helping you to achieve greater success - more on this in a future column and see Dwarak’s article. In the meantime, do consider applying - success reflects well on you, your unit and our specialty. Read the instructions carefully and, if possible, give comparative data to illustrate your contribution. Consider asking your regional Clinical Advisor for advice. Start planning now: The closing date for self-nominations this year is 1st September and the guide to the scheme will be published by the end of July.

BGS Leads
I continue to be astonished by the huge number of skilled, knowledgeable, wise and energetic people we have in our Society. In my plan to move to a more federal style in the BGS, I would like to expand the number of Leads or Champions in a number of areas - particularly in those aspects of health care that are topical and that are not necessarily covered by the Special Interest Groups and Sections. The idea is that one or more people will be nominated to be key people in these fields: they might go to specialist committee meetings, represent the BGS at other fora, be available to act as “instant experts” when an age-related news story is going to break, comment on important documents (to complement the work done by our retired Senior Advisers), keep an eye open for future trends (“horizon scanning”) and report back to the UKMC on progress and problems.

So far I have received enthusiastic offers of help on several subjects:- Academic Geriatrics (John Potter); Acute Medicine (Simon Conroy); Ageism and Inequalities (David Oliver and Mike Vassallo); Continuing Professional Development (Alan Sinclair); Commissioning (Ken Fullerton and Finbarr Martin); Dignity (Jackie Morris);
Leadership (David Black and Paul Knight)
Metrics and Dashboards (Owen David and Zoe Wyrko) ; NCEPOD ( Jugdeep Dhesi); Patient Safety (David Oliver); Quality (Adrian Wagg);
Revalidation (Peter Belfield and Linda Patterson);
Stroke (David Barer).

I would also like to appoint Leads on Liaison with Age Charities; Influenza; Integration (Primary and Secondary care); Innovation and Translational Research; the Economic Downturn, and Prevention and Health Promotion.

BGS Scotland
It was a great pleasure to be invited to the Scottish BGS meeting in May. Our CEO Alex Mair was also present as was Iona-Jane Harris, our new Press, P.R. and Parliamentary officer.

Scotland is the cradle of academic Geriatrics - Professor Ferguson Anderson held the world’s first Chair in Geriatrics in Glasgow. It was great to see the quality of the presentations by the trainees: there was a useful take-home message in every paper.

The meeting was one in which Geriatricians from Northern Ireland also took part and it was good to meet old friends from the Province.

We learned much about how the NHS is different north of the border - so far Scotland has resisted the move towards the market model of health care. There are no Trusts or PCTs and Darzi does not apply. Clinicians have easier access to politicians. Links with charities are strong. The Scottish government’s SIGN guidelines are always of high quality (the hip fracture report is particularly good). The Care Commission informs local Geriatric services of Care Homes in their patch that may be causing concerns.

Geriatrics in Scotland is in very good spirits. The Scottish BGS will celebrate its 50th anniversary in 2010: I am sure that its members will continue to do high quality research, provide excellent clinical services and champion the cause of old people

Congratulations
To Bim Bhowmick who was awarded the NHS Wales 2009 Lifetime Achievement Award for his outstanding contribution to NHS Wales and, in particular, the creation of the Advanced Clinical Assessment Team in Torfaen.

To Pradeep Khanna, who has been appointed as Visiting Professor at Glamorgan University. This is in recognition of his excellent work on Intermediate Care.

To David Oliver, our indefatigable secretary, who has become Visiting Professor to the City University in London (where the Chair has been dormant) -a well earned accolade.

To the members of the Falls and Bone Health SIG, whose Map of Medicine guideline on Falls is in the top ten sites visited - well done!

Graham Mulley

BGS Newsletter, July 2009
Issue 22 ISSN 1748-6343 22