Evidence submitted by the British Geriatrics
Society (ISTC 21)
THE BRITISH
GERIATRICS SOCIETY
The British Geriatrics Society (BGS) is the
only professional association, in the United Kingdom, for doctors
practising geriatric medicine. The 2,200 members worldwide are
consultants in geriatric medicine, the psychiatry of old age,
public health medicine, general practitioners, and scientists
engaged in the research of age-related disease. The Society offers
specialist medical expertise in the whole range of health care
needs of older people, from acute hospital care to high quality
long-term care in the community.
GERIATRIC MEDICINE
Geriatric Medicine (Geriatrics) is that branch
of general medicine concerned with the clinical, preventive, remedial
and social aspects of illness of older people. Their high morbidity
rates, different patterns of disease presentation, slower response
to treatment and requirements for social support, call for special
medical skills. The purpose is to restore an ill and disabled
person to a level of maximum ability and, wherever possible, return
the person to an independent life at home.
The Society welcomes the opportunity to contribute
to this debate and would comment on the particular questions below:
1. Are ISTCs providing value for money?
1.1 They are providing value for money but
in future, costings will need to include an element for delayed
discharge.
2. Does the operation of ISTCs have an adverse
effect on NHS services in their areas?
2.1 The operation of ISTCs could have an
adverse effect on NHS Services in their areas through the inevitable
selection of younger fitter people for simple procedures. This
could concentrate the levels of highly dependant older people
within the NHS services. Treatment centres could then be seen
to be ageist.
3. What arrangements are made for patient
follow-up and the management of complications?
3.1 If older people develop complications
they require rapid access to multi-disciplinary medical care.
In addition post operatively they will often need to have help
and support from the multi-disciplinary team of therapists and
social workers.
4. What role have ISTCs played and should
they play in training medical staff?
4.1 ISTCs should be made to share costs of
training health care professionals. There will be good training
opportunities but these would need to be regulated.
5. Are ISTCs providing care of the same
or higher standard as that provided by the NHS?
5.1 They should complement local health services
and not undermine them
6. What changes should the Government make
to its policy towards ISTCs in the light of experience to date?
6.1 In the light of experience to date ISTCs
need to take account of the multiple needs of older people. Who
are more likely to have multiple diseases and long- term conditions
associated with impairment, disability and handicap.
7. What criteria should be used in evaluating
the bids for the Second Wave of ISTCs?
7.1 The needs of older people.
8. What factors have been and should be
taken into account when deciding the location of ISTCs?
8.1 They need to be accessible for older
people ie near transport links.
Dr Jeremy R Playfer MD FRCP
President
The British Geriatrics Society
13 February 2006
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