Health and care systems across the UK are facing sustained workforce constraints at the same time as demand from an ageing population continues to rise. This British Geriatrics Society’s (BGS) report considers how healthcare services can make the best use of the limited and increasingly scarce resource of consultant geriatricians.
Providing a set of actionable recommendations:
- Rebalance geriatrician job plans to reflect population need. Organisations should actively protect time for leadership, service development, education and research, recognising these as essential components of delivering sustainable, high‑quality care for an ageing population.
- Prioritise geriatrician deployment to overseeing complex patients in high‑value settings. Services used by older people must be designed to maximise the impact of geriatrician expertise: enabling early senior decision‑making for people with frailty or complex needs, particularly at the front door, in hospital at home, and across key interfaces of care.
- Embed geriatric expertise in system planning and redesign. Geriatricians should be actively involved in healthcare planning and strategy at organisational and system level, ensuring that pathways and models of care are explicitly designed to meet the needs of older people as care shifts from hospital to community settings.
- Ensure that system leadership structures include geriatricians. Older people are the biggest group using healthcare services and have the most complex needs. Involving geriatricians in systems leadership will ensure that systems are designed for the needs of the people who use them the most and will unlock other system problems such as waiting times and delayed discharge.
- Ensure that geriatrician shortages are addressed in future training and development of the workforce. Given the current national shortage of geriatricians and the changing demographics, training and development of geriatricians of the future should be prioritised in order to meet the BGS’s suggested ratio of one full time equivalent geriatrician per 500 people aged 85 and over.
- Reform medical training to ensure that the next generation of doctors is prepared to care for the ageing population. Training in all specialties should be widened to embed GIM in the curriculum for all specialties. The role of geriatricians in training the next generation of physicians should be recognised and expanded.
- Ensure that geriatricians are supported to add value beyond their clinical roles. Geriatricians have much to add outside of clinical roles including in research and training. Job plans must be flexible enough to allow for these additional responsibilities.
- Embed geriatric medicine at all stages of the curriculum
Older people use health services more than any other population group and therefore geriatric medicine must be embedded at all stages of medical training from undergraduate study through to resident doctor training. - Ensure geriatric medicine trainees have exposure to community-based working during their training. As we shift to providing more care outside of the hospital environment, it is crucial that the geriatricians of the future have the skills needed to provide care in community-based settings. Placements in community teams should be a core part of their training.
- Adopt a proportionate approach to GIM delivery across specialties. Geriatricians should continue to contribute to General Internal Medicine, including the care of younger adults where appropriate, but the time allocated to undifferentiated GIM activity should be proportionate to that of other physician specialties, both during training and after CCT.
To read the full report please visit the BGS website.