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NEWS: Chief medical officer calls for generalist doctors as population ages

Doctors need to maintain “generalist” skills in order to provide care for growing numbers of elderly people with multi-morbidity, the chief medical officer for England has said.

CMO Professor Chris Whitty said that governments had not planned adequately for this growing population – warning that the elderly are increasingly concentrated in coastal and rural areas. In these areas, they have poor transport links and inadequate infrastructure for the elderly. Professor Whitty says it should be a priority to improve the environment in these areas to give the elderly the greatest independence.

The report was welcomed by GP leaders who stressed their teams are “highly trained” to help these patients. Professor Whitty says that medical specialisation, specialist NHS provision, research and clinical guidelines all focus on single diseases – and this is not the reality for most elderly people.

Professor Whitty said: “Maximising the quality of health in older adults should be seen as a major national priority – we can make very significant progress with relatively straightforward interventions. Older people can and should be better served. We need to recognise and reflect in policy and medical practice where older people are concentrated geographically, increase clinicians’ generalist skills, improve mental health provisions and make it unacceptable to exclude older adults from research because of older age or common comorbidities.”

The president of the British Geriatrics Society, Professor Adam Gordon, said: “The Chief Medical Officer is also right to highlight the challenges associated with more people living with complex health and care needs, including increasing levels of frailty and multimorbidity. Inequalities are increasing across our society, with some people enjoying excellent health into their later years and others spending many years living in poor health. There are not enough specialists working in older people’s healthcare and not enough healthcare professionals have developed the right skills to care for this growing population group.

“The Chief Medical Officer’s call to recognise this as a major national priority is very timely – we are all ageing and we must act now to grasp this opportunity, ensuring that older people now and in the future are enabled to live healthy, independent lives for as long as possible.”

Royal College of GPs chair Professor Kamila Hawthorne said: “While it’s a testament to advances in medicine that patients are living for longer – as they do – they are often living with multiple, chronic health conditions. This is something that GPs and our teams are highly trained to manage and treat, and we are pleased this is recognised in the latest chief medical officer’s report. Today’s report highlights the utmost importance in resourcing general practice appropriately for the future, given that as our patients grow older and have more complex health conditions, need for GP care grows in both volume and complexity.”

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