Email your comments

The Royal College of Physicians of London hosted a highly successful one-day conference on nursing home medicine, on 30 June.

Care homes are now very much in the news - the Glasgow College had previously organised a similar conference. Peter Crome is to be congratulated on designing and organising such a splendid day. The College President, Ian Gilmour, opened the proceedings. It was great to see over 170 delegates - many of them young, most from our specialty, but also colleagues from Rehabilitation Medicine, Palliative Care, General Practice and other medical specialties, as well as people from the Care Quality Commission, several charities, nurses, therapists and many others.

The fact that five of the speakers were UK Professors of Elderly Medicine, testifies to the upsurge of professional interest in the care of the most disadvantaged old people (in the UK, there are about 450,000 residents in Care Homes; about one in three old women and one in six old men will spend some time in such homes).

Each speaker - who included a nurse and representatives of the private and voluntary sectors - spoke with verve and enthusiasm and everyone to whom I spoke was well pleased with the day. Delegate feedback was very good indeed; we are grateful for the positive comments which will enable us to ensure that future symposia are of an even higher standard.

For your diaries
The BGS is involved in four further events (apart from our usual scientific conferences). Firstly, there will be a free workshop on Commissioning (see page 20), two BGS/ RCP events on Neurology of Old Age (18 February 2010), ‘Red Flags in Medicine’ (8 June 2010), and a BGS event on Interface Geriatrics (5 March 2009). Please note these dates in your diary and try to attend. Do also try to go to the RCPL study day on “Anorexia, Cachexia and Fatigue” on 26 November 2009. These topics are important components of the frailty syndrome and there will be opportunities to share ideas with colleagues from UK and overseas speakers in different disciplines

Public Relations Priorities
At the last UKMC, the committee discussed the key topics that the BGS should focus on as PR priorities. I was delighted that Care Homes received the most votes - there is much to be done to improve the public’s awareness of the good practice that occurs in many homes. Channel Four is doing a series on this soon, with a welcome emphasis on the positive aspects of long term care. I have spoken to Pauline Ford at the Royal College of Nursing on ways in which the BGS and RCN might work together on better care in residential and nursing homes. A first step is to improve teaching and training. I am delighted that Eileen Burns has offered her services as BGS national Lead on Care Homes.

The second topic chosen was Prevention. I feel that though we may practice this to some extent, we may not always take the opportunity to use clinical encounters to educate patients and their families in how to eat, drink and exercise better, as well as practice secondary and tertiary (prevention of complications) prevention. The pioneers in this field were J A Muir Gray, a community physician from Oxford (“Prevention of Disease in the Elderly“ was published in 1985) and David Kennie, a geriatrician at Stirling Royal Infirmary , whose excellent monograph “Preventive Care for Elderly People” appeared in 1993, and is still well worth reading.

Prevention is repeatedly emphasised in Lord Darzi’s Next Stage Review. In England, the Department of Health has just published “Building a Society for Care Services for all Ages”, emphasising that prevention forms the main part of the government’s ageing strategy. In choosing this subject as a key theme, we are therefore pushing at an open political door. and I am very pleased that our national Lead on Prevention is Tash Masud.

Undergraduate Teaching
I returned to my old stamping ground of Nottingham Medical School to be part of the celebration of 30 years’ undergraduate teaching in Health Care of the Elderly. Tom Arie, the first professor in elderly care in Nottingham, was on excellent form and tributes were paid to his visionary approach - particularly the joint working, in teaching as well as service delivery, of physicians and psychiatrists in elderly care. His book on “Health Care of the Elderly (Croom Helm, 1984) contains many diamonds - especially Roy Boyd’s superb essay on, “What is a ‘social problem’ in Geriatrics?”

My role was to explain what the BGS does for undergraduates.

I learned that Nottingham and district has two more geriatric professors to add to John Gladman, Rowan Harwood and Tash Masud. My heartiest congratulations to Opinder Sahota (Professor of Medicine of Older People and Bone Health) and Jagdish Sharma (Professor of Medicine of Older People). Tom Arie must be very pleased that he has been replaced by five professors!

Patient Safety
This is another important area and one which is rightly receiving much current attention. Like prevention, it is emphasised in the Darzi report. The recent House of Commons Health Committee’s report on “Patient Safety” rather underplays the importance of falls in hospital but it is a hard hitting document that deserves close study. You might also read the publications of the National Patient Safety Agency and the summary of reports made by Coroners in England and Wales giving details on deaths (including those in hospitals, care homes and the community) and scope for preventative action. The “Summary of reports under Rule 43 of the Coroner’s Rules” - not the most arresting of titles! - is here . Ali Cracknell will be working with David Oliver as BGS Leads on this subject

Flu vaccine
And as a final thought - do remember to have a flu vaccine. It may benefit you as well as reduce the risk of infection to your patients

Graham Mulley

BGS Newsletter, September 2009
Issue 23 ISSN 1748-634000 23