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BMJ No 7115 Volume 315 News Saturday 25 October 1997 Training in care of elderly needs to improve Leading specialists in the care of elderly people are launching a concerted attack on medical training, research, and services for older people. The first salvo is a national audit for the year 2000 to give a clear picture of how well current training and services meet their health needs. The recommendation comes in a report, The Impact of Ageing, published last week by the charity Research for Ageing. The advisory panel, including representatives from medicine, nursing, the Department of Health, and the Audit Commission, reviewed a large body of evidence showing that current health services tend to give elderly people low priority, and it warned that services for older people must be improved. "Older people are still often denied access to the full range of therapies from which they can benefit," said Brian Livesley, convenor of the expert group, and professor in the care of the elderly at the University of London. Work on the national audit for the year 2000 is beginning at once, with the evaluation of all medical examinations - both undergraduate and postgraduate - in Britain to see whether they include questions on the care of elderly people. "I expect this will show much that needs correcting," said Professor Livesley. "From now on all doctors, nurses, and therapists must learn how to care for older people - anything else wastes precious NHS resources and fails this increasing proportion of our population," Professor Livesley pointed out. By the year 2000, two million more pensioners will have joined the 10 million already in Britain. There are now 50% more people over the age of 60 than there were 30 years ago. This has been accompanied by a steady increase in the proportion of elderly patients in NHS hospitals - latest figures show that up to 65% of all beds for adults are now occupied by people over 60. The report points out that there are not enough posts in geriatric medicine departments for all junior doctors to be attached on rotation for a reasonable time, so other methods of training need to be developed - possibly short courses in geriatrics for other specialties. The report also calls for action from commissioners, suggesting that they should demand that all hospital and community trusts employ staff skilled in the care of elderly people and develop new performance indicators relating to elderly patients' perception of their care. Urgent improvements in training in the care of elderly people were also called for by the British Geriatrics Society at its recent scientific meeting marking its 50th anniversary. The president of the society, Dr Arup Banerjee, who is a consultant physician at the Royal Bolton Hospital, pointed out the paradox of bed blocking by elderly patients: "Older people are blamed for blocking beds. But this wait is often caused by lack of proper assessment or early intervention - patients are misplaced or are not provided with the adequate ongoing care they require." He supports finding radical solutions, such as specialist geriatricians carrying out regular clinics in general practice, to improve the care of elderly patients in the community. Susan Mayor London Home | Current issue | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline