BGS sounds the alarm as winter approaches

15 November 2023

In January this year, we published a statement about protecting the rights of older people to health and social care. We wrote this statement as a response to the situation facing healthcare professionals across the country over the winter. The impact of the ongoing crisis in health and social care on older people was significant and led to many in the workforce feeling overwhelmed and disempowered. They were in no doubt that people died or were left permanently disabled because healthcare professionals were unable to provide the care that they desperately wanted to.

Our statement sounded the alarm on the damaging effects of poor care for older people, and set out both medium and long-term solutions to the crisis in health and social care. It was supported by the Royal College of Physicians London and the Royal College of Physicians of Edinburgh. The statement resonated widely and 23 additional organisations contacted us to support it. 

Unfortunately, not enough has changed during the year and we are fast approaching a winter which threatens to be just as bad as the last. It is for this reason that we have updated and reissued our statement.

There has been some progress this year, such as the publication of the NHS Long Term Workforce Plan and the Intermediate Care Framework. However, older people are still getting stuck in hospital because of a lack of social care and rehabilitation in the community. In September 2023, 12,667 people were in hospital in England who no longer met the criteria to reside. This is only marginally down from the previous year when 13,514 remained in hospital who did not need to be there. Ambulance and emergency department waiting times have not improved and research shows that older people are more likely to wait longer in emergency departments than other age groups. 

We are calling on governments across the UK to act now to ensure that this winter, older people have access to the health and social care that they need. Once again, a range of medical and third sector organisations have chosen to support our statement, showing the strength of feeling on this issue.  

Professor Adam Gordon, President of the British Geriatrics Society, said: 

The BGS feels compelled to sound the alarm again for a winter that promises to be just as challenging as the last for our health and social care services. Healthcare professionals are already exhausted and have experienced moral injury as a result of being unable to provide the high-quality care that they want to. It will be older people who pay the price for this shortfall in care, which must be addressed.  We cannot continue like this.” 

Dr Sarah Clarke, President of the Royal College of Physicians, said: 

We echo the calls of the BGS to improve the delivery of high quality and personalised care for older people with frailty. Optimising evidence-based interventions for frailty, ensuring timely referral to specialty geriatric colleagues and appropriate referral to social and community care support before admission to hospital becomes necessary, is vital. 

As outlined by the Chief Medical Officer’s recently-published annual report, there are significant disparities in health among older populations throughout the country. Social determinants, such as access to infrastructure, green spaces, air pollution and many more factors contribute to ill health in older age.  

Fundamentally, we must see a more preventative approach to health across all age groups and communities which is why we call for a cross-government strategy to tackle health inequalities.”  

Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh, said: 

Hospitals across our NHS have faced challenges in supporting the timely discharge of older patients for many years. These delays in discharge at the 'back door' of hospitals are harmful to patients and their families – but there is now clear evidence that they also cause harm to other patients, by impairing flow through hospitals, and by contributing to waits for acute admission, to time spent on trolleys and to the numbers of ambulances queueing. The problems of the front door of our hospitals will never be solved until the problems at the back door are solved. We urge government to redouble all efforts in this regard.” 

Mr Michael McKirdy, President of the Royal College of Physicians and Surgeons of Glasgow, said: 

We are all aware of the challenges of delivering good care to older people in our current NHS and social care systems. Therefore the Royal College of Physicians and Surgeons of Glasgow strongly supports this statement from the British Geriatrics Society, which sets out actions that can be taken now to improve care in the coming winter. We call on all four nations to respond, quickly and positively, to these recommendations.”