BGS Scotland


Scottish Care of Older People Audit

The evidence base for specialist led coordinated organised services is stronger than ever with an update of the Cochrane review expected imminently to conform that some benefits (avoidance of Nursing Home) may start as early as the point of discharge.

In other specialties such as Stroke or Orthopaedics (Hip Fracture), national audits and benchmarking of services have led directly or indirectly to a focus on improvement.  Often this has resulted in improved services.

In a partnership between the University of Aberdeen, Healthcare Improvement Scotland and BGS Scotland, we are announcing the development of a national benchmarking of CGA services.  This will be developed in an interactive fashion and we are not naïve to the scale and complexity of the challenge!  A similar (voluntary) exercise was undertaken in England and can be found here.

Longer term our hope is that this might also prove the springboard to investigate correlations between process and outcome in service delivery.

In the meantime however we plan to establish the metrics.  Whilst we would aim to make this as undemanding as possible for boards, we are likely to need close cooperation with colleagues at board level to collect data.

Meanwhile watch this space!  We hope to have a website available shortly to give updates on the development and progress of the initiative.

Graham Ellis
Phyo Myint

BGS Scotland

BGS Scotland is the professional organisation of doctors who specialise in the medicine of old age in Scotland. The branch has 280 or so members and is affiliated to the main British Geriatrics Society in London (BGS).

We welcome suggestions and input from members of BGS Scotland or from representatives of organisations sharing the interests of the Society. Contact the Web Editor, Dr Allan MacDonald of Belford Hospital.

Hospital at Home Forum at the BGS Autumn Meeting

Dr Graham Ellis is an Associate Medical Director and Older Peoples Services Consultant Geriatrician for NHS Lanarkshire. He is also one of the key speakers at the Hospital at Home UK Forum at the BGS Autumn Meeting on Wednesday 23rd November in Glasgow. 

home-heartOlder people are presenting to acute hospitals in greater numbers year on year. Predictions of the future demographic raise serious questions about the sustainability of hospital based services. The Future Hospitals Commission recommended the development of specialist hospital services in the community delivering new and innovative services closer to the point of need.

Older people’s services in particular are challenged to meet existing and predicted demand. Recent headlines have highlighted inadequate alternatives to admission for older people. Yet older people should receive high quality, safe and effective care best suited to their needs that includes Comprehensive Geriatric Assessment. Services need to be designed from a patient centred perspective, but they must also be high-quality, safe and affordable. (more…)

Why do older people get less palliative care than younger people?

A paper written by Anna Lloyd and her colleagues, and published in the European Journal of Palliative Care analysed data from four studies into the end-of-life experiences of people with glioma, bowel cancer, liver failure and frailty. They found that patients aged 70 and over received less palliative care.

In summary, the team found that:

  • A secondary analysis of data from four studies on the end-of-life experiences of people with glioma, bowel cancer, liver failure and frailty suggests that older patients (aged 70 and over) have more untreated pain, less access to generalist and specialist palliative care, and greater information needs than younger patients
  • In older people, there are less clear early signs indicating that they need, and triggering their referral to, palliative care. The lack of a clear diagnosis of dying and the association of palliative care with cancer also hinders older people’s access to good end-of-life care.
  • More efforts should be made to identify older patients who would benefit from a palliative care approach in all settings.

Read the full paper here

Thousands of care home places lost since turn of the century

Thousands of care home places in Scotland have been lost since the onset of devolution prompting fears that the country’s “most vulnerable” are suffering and demands for government action. There are now claims that ministers have failed to plan for the impact of an ageing population, despite repeated warnings. But the Scottish Government says its policies are now directed towards ensuring that people can live independently to an older age in their own homes. The number of registered care homes places fell by 3,685 since the turn of the century to 42,026 last year, according to official Scottish parliament figures. This includes 83 fewer local authority and NHS places last year, 290 fewer spaces in private facilities, and 103 fewer in voluntary facilities compared to 2014.
Read more in The Scotsman