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The NHS is now providing the “worst care for older people” since metrics began due to a shortage of geriatricians who specialise in care of older people, a new report from the British Geriatrics Society (BGS) has found.
The report, The case for more geriatricians: Strengthening the workforce to care for an ageing population reveals significant variation across the UK in the number of geriatricians available to care for older people.
While there are 282 geriatricians for approximately every million people over the age of 65 years old in London, there are only 96 for a similar population in the East Midlands. This means that there are parts of the country where the lack of geriatricians results in older people waiting longer to receive a level of care that is inferior to what they would expect and to what their clinicians would wish to provide.
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Professor Adam Gordon, President of the British Geriatrics Society, said: “Despite staff working flat out, the NHS is now providing the worst care for older people since metrics began. A major limitation is that in many parts of the country there is a shortage of professionals who specialise in care of older people. This means that we struggle to deliver both existing services and the new models of care needed to make things better.
“If we fix the NHS for older people, we fix it for everyone. The BGS calls on the government, NHS, education providers and health service leaders to urgently act to recruit and train more geriatricians. This is a matter of existential importance for our health service.”
Older people deserve better care
Geriatricians are specialists in healthcare for older people, particularly focusing on those patients with frailty and complex long-term conditions.
As the number of people with frailty and long-term conditions increases, the BGS has called on the government to plan ahead for an ageing population. It has identified six areas that could help make up the shortfall in consultant geriatricians urgently. These are:
- A UK-wide target of one consultant geriatrician per every 500 people aged 85 and over to be used as the basis of consultant workforce and training projections.
- An urgent expansion of National Training Numbers in geriatric medicine to allow for the above. The BGS estimates this will require an additional 300 geriatric medicine National Training Numbers per year to meet the proposed target by 2030, if recruitment were to start in 2024.
- An urgent increase in the number of ST4 geriatric medicine posts available to support the expansion in national training numbers.
- Detailed work to establish the number of additional training posts per annum on a deanery-by-deanery basis, with a view to meeting the proposed target across all deaneries by 2030.
- Continuous review of the above requirements taking account of the number of trainees in Less Than Full Time employment and the projections on numbers of geriatricians retiring.
- A national recruitment drive, highlighting the importance of geriatric medicine, and career opportunities within the specialty. This should complement materials focused on expanding the numbers of nurses, allied healthcare professional and advanced clinical practitioners choosing a career in older people’s healthcare.
Dr Amit Arora, Vice President for Workforce of the BGS, added: “How a country looks after its older people is a measure of societal attitudes. Getting the care of older people right holds the key to many of the capacity challenges currently facing the NHS.
“This report will help to initiate the necessary conversations to support recruitment, retention, development and support for a multidisciplinary workforce caring for older people. This starts with recruiting the geriatrician numbers that we need, to maintain and lead further developments in the care of our ageing population. Older people deserve no less. The opportunity is huge and the time is now.”