Careers

Speaking out David Oliver rose quickly through the ranks of medicine to become a leading figure in the development of improved services for older people. He talks to Daniel Allen about his early days as a doctor, his career trajectory and his new role at the British Geriatrics Society

DAVID OLIVER has been liberated. As a former national clinical director for older people’s services, he adapted to the limitations imposed on clinicians who take on a government role. Now, though, he is free to speak his mind and does so frequently online and in print, often pointing out the contradictions and inconsistencies in the way older people’s care is organised – or, in some cases, disorganised. As the newly installed president of the British Geriatrics Society (BGS), Professor Oliver will surely be making his opinions heard even more widely as he slides his feet under the desk. He has been in medicine for 30 years, after training at Oxford and then Cambridge, and was drawn to become a doctor because it combined a focus on people with a strong scientific base. Many close family members were in public service roles such as health care or teaching, and a job in business or finance was never on the cards. As his career began, he was soon attracted to working with older people. ‘I liked the way the geriatricians went about their business,’ he says. ‘I also like the fact that working with older people calls for a holistic, biopsychosocial approach to medicine. It’s not just about dealing with a single disease.’ He enjoyed, too, addressing the ethical and legal dilemmas that older people’s care demands. ‘It’s not for every doctor but it suited me,’ he says. From early in his career he liked taking on ‘anything that was a bit peripheral’ NURSING OLDER PEOPLE

to his central clinical role – health policy and leadership, for example – and by the age of 32 he was a consultant and running a hospital department. ‘I realise now they were just dumping work on me but it meant I got the experience of having to provide leadership early in my career.’ National role At the now Royal Berkshire NHS Foundation Trust he led innovative service changes that included the establishment of dementia-friendly wards and rapid assessment clinics for older people. With considerable experience behind him, as a clinician and a service leader, he was appointed national clinical director for older people in 2010. The role mixes parliamentary business such as briefing ministers with an outward-facing element – being on the road, giving talks and undertaking site visits. Because it is a seconded, half-time position, the postholder also continues with clinical work. ‘It changes you forever,’ Professor Oliver says. ‘You no longer see things in transactional, straightforward ways. You have to get a much broader range of understanding across government, not just medicine.’ It is also a demanding role and after three years he stepped down. ‘But I landed on my feet,’ he says. Other offers quickly came his way, including work for the King’s Fund on integrated care for older people and advising the NHS emergency care intensive support team, as well as

invitations to write and blog for various journals and organisations. He has held other BGS roles in the past and took over the presidency in October. The BGS is the largest specialty medical society, with nearly 3,000 members, mostly doctors, but he is keen for more nurses to join. The society is collaborating with the RCN and the two have run joint conferences. He is critical of the way nurses who work with older people are sometimes portrayed in the lay press. ‘Nursing someone who is old and frail with complex needs is a skilled endeavour. But people try and make it seem like it’s just common sense, compassion, empathy.’ He thinks that nurses and doctors have insufficient training in the care of older people who, because of their growing numbers, are becoming healthcare’s ‘core business’. He says: ‘I’m not sure that knowledge and training have kept up with that reality,’ adding that caring for frail older people is low in the ‘unwritten hierarchy of prestige’ compared, say, with looking after patients in coronary or intensive care. ‘We’ve got to shift that.’ But for all the gaps in knowledge and provision, he says there are many examples of innovative services for older people that clinicians should be proud of. ‘There’s a lot of good stuff going on,’ he says, ‘and nurses have a key role in doing it.’ Daniel Allen is a freelance writer December 2014 | Volume 26 | Number 10 41

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Speaking out.

DAVID OLIVER has been liberated. As a former national clinical director for older people's services, he adapted to the limitations imposed on clinicia...
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