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"nid" => array:1 [
0 => array:1 [
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]
]
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0 => array:1 [
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]
]
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]
]
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]
]
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0 => array:3 [
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"dependencies" => array:1 [
"module" => array:2 [
0 => "menu_ui"
1 => "scheduler"
]
]
"third_party_settings" => array:2 [
"menu_ui" => array:1 [
"parent" => "main-menu:0:"
]
"scheduler" => array:10 [
"expand_fieldset" => "when_required"
"fields_display_mode" => "vertical_tab"
"publish_enable" => true
"publish_past_date" => "error"
"publish_required" => false
"publish_revision" => false
"publish_touch" => false
"unpublish_enable" => true
"unpublish_required" => false
"unpublish_revision" => false
]
]
"name" => "Resource"
"type" => "resource"
"description" => null
"help" => null
"new_revision" => true
"preview_mode" => 1
"display_submitted" => false
]
"bundle" => "node_type"
]
]
"revision_timestamp" => array:1 [
0 => array:1 [
"value" => "1732182382"
]
]
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0 => array:3 [
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0 => array:1 [
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]
]
"uuid" => array:1 [
0 => array:1 [
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]
]
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0 => array:1 [
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]
]
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0 => array:1 [
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]
]
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0 => array:1 [
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]
]
"preferred_admin_langcode" => []
"name" => array:1 [
0 => array:1 [
"value" => ""
]
]
"pass" => []
"mail" => []
"timezone" => array:1 [
0 => array:1 [
"value" => ""
]
]
"status" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"created" => array:1 [
0 => array:1 [
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]
]
"changed" => array:1 [
0 => array:1 [
"value" => "1706607980"
]
]
"access" => array:1 [
0 => array:1 [
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]
]
"login" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"init" => []
"roles" => []
"default_langcode" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"revision_default" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"revision_translation_affected" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"metatag" => array:3 [
0 => array:2 [
"tag" => "meta"
"attributes" => array:2 [
"name" => "title"
"content" => "user | British Geriatrics Society"
]
]
1 => array:2 [
"tag" => "meta"
"attributes" => array:2 [
"name" => "description"
"content" => "British Geriatrics Society"
]
]
2 => array:2 [
"tag" => "link"
"attributes" => array:2 [
"rel" => "canonical"
"href" => "not yet assigned"
]
]
]
"role_change" => array:1 [
0 => array:1 [
"target_id" => "__role_delegation_empty_field_value__"
]
]
"revision_created" => array:1 [
0 => array:1 [
"value" => "1706607980"
]
]
"revision_user" => array:1 [
0 => array:3 [
"target_id" => "0"
"message" => "Recursion detected."
"array_path" => "revision_uid.0.entity"
]
]
"revision_log_message" => []
"path" => array:1 [
0 => array:1 [
"langcode" => "en"
]
]
"civicrm_contact_place_of_work" => array:1 [
0 => array:1 [
"" => ""
]
]
"civicrm_contact_region" => array:1 [
0 => array:1 [
"" => ""
]
]
"civicrm_contact_biography" => array:1 [
0 => array:1 [
"" => ""
]
]
"civicrm_contact_prefix" => array:1 [
0 => array:1 [
"" => ""
]
]
"civicrm_contact_job_title" => array:1 [
0 => array:1 [
"" => ""
]
]
"field_blog_subscribers" => []
"field_e_bulletin" => []
"field_events_e_bulletin_" => []
"field_legacy_id" => []
"field_member_alert" => []
"field_metatag" => []
"field_national_council_bulletin_" => []
"field_nurses_and_ahp_bulletin" => []
"field_privacy_statement" => []
"field_region_bulletin_" => []
"field_sig_and_section_bulletins_" => []
"field_special_interest_groups" => []
"field_sponsored_e_bulletin" => []
"field_trainees_bulletin_" => []
"user_picture" => []
]
"bundle" => "user"
]
]
"revision_log" => []
"status" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"uid" => array:1 [
0 => array:3 [
"target_id" => "14122"
"entity" => array:46 [
"uid" => array:1 [
0 => array:1 [
"value" => "14122"
]
]
"uuid" => array:1 [
0 => array:1 [
"value" => "17c65cc6-2224-4427-9b62-68a46e795414"
]
]
"revision_id" => array:1 [
0 => array:1 [
"value" => "84032"
]
]
"langcode" => array:1 [
0 => array:1 [
"value" => "en"
]
]
"preferred_langcode" => array:1 [
0 => array:1 [
"value" => "en"
]
]
"preferred_admin_langcode" => []
"name" => array:1 [
0 => array:1 [
"value" => "Amy Brewerton"
]
]
"pass" => array:1 [
0 => array:1 [
"value" => "$2y$10$Q4XqfSgxpzwcU7WTUs6iX.9tXvemS3JrPIWGVJbY/dUH173.AMAky"
]
]
"mail" => array:1 [
0 => array:1 [
"value" => "publishing@bgs.org.uk"
]
]
"timezone" => array:1 [
0 => array:1 [
"value" => "Europe/London"
]
]
"status" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"created" => array:1 [
0 => array:1 [
"value" => "1707470552"
]
]
"changed" => array:1 [
0 => array:1 [
"value" => "1729758232"
]
]
"access" => array:1 [
0 => array:1 [
"value" => "1731926930"
]
]
"login" => array:1 [
0 => array:1 [
"value" => "1731926187"
]
]
"init" => []
"roles" => array:6 [
0 => array:3 [
"target_id" => "member"
"entity" => array:9 [
"uuid" => "ae48c1c2-722e-4c10-82a8-7859afad1f5d"
"langcode" => "en"
"status" => true
"dependencies" => array:1 [
"module" => array:1 [ …1]
]
"id" => "member"
"label" => "Member"
"weight" => 2
"is_admin" => null
"permissions" => array:3 [
0 => "access comments"
1 => "access user profiles"
2 => "post comments"
]
]
"bundle" => "user_role"
]
1 => array:3 [
"target_id" => "administrator"
"entity" => array:10 [
"uuid" => "2a4bc869-22a5-4c08-ae59-8014c0cf8bd0"
"langcode" => "en-gb"
"status" => true
"dependencies" => []
"_core" => array:1 [
"default_config_hash" => "OeKGIkmZA_c-t6QLH81WNQx8gDCc1MRmxaTuQgxBByU"
]
"id" => "administrator"
"label" => "Administrator"
"weight" => 3
"is_admin" => true
"permissions" => []
]
"bundle" => "user_role"
]
2 => array:3 [
"target_id" => "website_editor"
"entity" => array:9 [
"uuid" => "14d4b835-9f76-4781-b7ef-f1b1fc2eec0a"
"langcode" => "en"
"status" => true
"dependencies" => array:2 [
"config" => array:17 [ …17]
"module" => array:9 [ …9]
]
"id" => "website_editor"
"label" => "Website editor"
"weight" => 4
"is_admin" => null
"permissions" => array:73 [
0 => "access administration pages"
1 => "access content"
2 => "access content overview"
3 => "access toolbar"
4 => "access user profiles"
5 => "bypass honeypot protection"
6 => "create blog content"
7 => "create event content"
8 => "create external_course content"
9 => "create external_event content"
10 => "create external_jobs content"
11 => "create form content"
12 => "create member_update content"
13 => "create news content"
14 => "create paragraph content attachment"
15 => "create paragraph content attachments"
16 => "create paragraph content faqs"
17 => "create paragraph content faqs_accordion"
18 => "create paragraph content links"
19 => "create paragraph content quote"
20 => "create paragraph content team"
21 => "create paragraph content video"
22 => "create paragraph content wysiwyg"
23 => "create policy_update content"
24 => "create publication content"
25 => "create resource content"
26 => "create resource_series content"
27 => "create webform content"
28 => "delete any event content"
29 => "delete any form content"
30 => "delete any publication content"
31 => "delete any webform content"
32 => "delete paragraph content attachment"
33 => "delete paragraph content attachments"
34 => "delete paragraph content faqs"
35 => "delete paragraph content faqs_accordion"
36 => "delete paragraph content link_flexi"
37 => "delete paragraph content links"
38 => "delete paragraph content q_a"
39 => "delete paragraph content team"
40 => "delete paragraph content video"
41 => "edit any blog content"
42 => "edit any event content"
43 => "edit any external_jobs content"
44 => "edit any form content"
45 => "edit any news content"
46 => "edit any policy_update content"
47 => "edit any publication content"
48 => "edit any resource content"
49 => "edit any system_page content"
50 => "edit any webform content"
51 => "edit own external_course content"
52 => "edit own external_event content"
53 => "schedule publishing of nodes"
54 => "search content"
55 => "update paragraph content attachment"
56 => "update paragraph content attachments"
57 => "update paragraph content faqs"
58 => "update paragraph content faqs_accordion"
59 => "update paragraph content links"
60 => "update paragraph content q_a"
61 => "update paragraph content quote"
62 => "update paragraph content team"
63 => "update paragraph content video"
64 => "update paragraph content wysiwyg"
65 => "use admin toolbar search"
66 => "use advanced search"
67 => "use text format filtered_html"
68 => "use text format full_html"
69 => "use text format title"
70 => "view own unpublished content"
71 => "view scheduled content"
72 => "view the administration theme"
]
]
"bundle" => "user_role"
]
3 => array:3 [
"target_id" => "web_admininstrator"
"entity" => array:9 [
"uuid" => "15898fd0-081b-4594-a523-c4cd7df979e6"
"langcode" => "en"
"status" => true
"dependencies" => array:2 [
"config" => array:29 [ …29]
"module" => array:10 [ …10]
]
"id" => "web_admininstrator"
"label" => "Web admininstrator"
"weight" => 5
"is_admin" => null
"permissions" => array:116 [
0 => "access administration pages"
1 => "access comments"
2 => "access content overview"
3 => "access user profiles"
4 => "access users overview"
5 => "administer comments"
6 => "administer nodes"
7 => "administer users"
8 => "bypass honeypot protection"
9 => "create blog content"
10 => "create country content"
11 => "create event content"
12 => "create external_event content"
13 => "create external_jobs content"
14 => "create group content"
15 => "create member_update content"
16 => "create news content"
17 => "create page content"
18 => "create person content"
19 => "create policy_update content"
20 => "create promo content"
21 => "create publication content"
22 => "create resource content"
23 => "create resource_series content"
24 => "create simpleads content"
25 => "create slide content"
26 => "create team content"
27 => "create url aliases"
28 => "create users"
29 => "create vimeo_stream content"
30 => "create voting_form content"
31 => "delete any blog content"
32 => "delete any country content"
33 => "delete any elearning_module content"
34 => "delete any event content"
35 => "delete any external_course content"
36 => "delete any external_event content"
37 => "delete any external_jobs content"
38 => "delete any group content"
39 => "delete any member_update content"
40 => "delete any news content"
41 => "delete any page content"
42 => "delete any person content"
43 => "delete any policy_update content"
44 => "delete any promo content"
45 => "delete any publication content"
46 => "delete any resource content"
47 => "delete any resource_series content"
48 => "delete any simpleads content"
49 => "delete any slide content"
50 => "delete any team content"
51 => "delete any vimeo_stream content"
52 => "delete any voting_form content"
53 => "delete any webform content"
54 => "delete own blog content"
55 => "delete own elearning_module content"
56 => "delete own external_course content"
57 => "delete own external_event content"
58 => "delete own group content"
59 => "delete own member_update content"
60 => "delete own news content"
61 => "delete own policy_update content"
62 => "delete own resource content"
63 => "delete own resource_series content"
64 => "delete own simpleads content"
65 => "delete own voting_form content"
66 => "delete own webform content"
67 => "edit any blog content"
68 => "edit any country content"
69 => "edit any elearning_module content"
70 => "edit any event content"
71 => "edit any external_course content"
72 => "edit any external_event content"
73 => "edit any external_jobs content"
74 => "edit any form content"
75 => "edit any front content"
76 => "edit any group content"
77 => "edit any member_update content"
78 => "edit any news content"
79 => "edit any page content"
80 => "edit any person content"
81 => "edit any policy_update content"
82 => "edit any promo content"
83 => "edit any publication content"
84 => "edit any resource content"
85 => "edit any resource_series content"
86 => "edit any simpleads content"
87 => "edit any slide content"
88 => "edit any system_page content"
89 => "edit any team content"
90 => "edit any vimeo_stream content"
91 => "edit any voting_form content"
92 => "edit any webform content"
93 => "edit own blog content"
94 => "edit own elearning_module content"
95 => "edit own external_course content"
96 => "edit own external_event content"
97 => "edit own group content"
98 => "edit own member_update content"
99 => "edit own news content"
100 => "edit own policy_update content"
101 => "edit own resource content"
102 => "edit own resource_series content"
103 => "edit own simpleads content"
104 => "edit own voting_form content"
105 => "edit own webform content"
106 => "masquerade as any user"
107 => "post comments"
108 => "schedule publishing of nodes"
109 => "use advanced search"
110 => "use text format filtered_html"
111 => "use text format full_html"
112 => "use text format title"
113 => "view own unpublished content"
114 => "view scheduled content"
115 => "view the administration theme"
]
]
"bundle" => "user_role"
]
4 => array:3 [
"target_id" => "bgs_civi_administrator"
"entity" => array:9 [
"uuid" => "f978bdf6-7688-4e61-8cb0-2e81df532e91"
"langcode" => "en"
"status" => true
"dependencies" => array:2 [
"config" => array:27 [ …27]
"module" => array:24 [ …24]
]
"id" => "bgs_civi_administrator"
"label" => "BGS civi administrator"
"weight" => 6
"is_admin" => null
"permissions" => array:174 [
0 => "access administration pages"
1 => "access content"
2 => "access content overview"
3 => "access contextual links"
4 => "access devel information"
5 => "access security review list"
6 => "access site in maintenance mode"
7 => "access site reports"
8 => "access user profiles"
9 => "access users overview"
10 => "add JS snippets for google analytics"
11 => "administer content types"
12 => "administer devel menu items"
13 => "administer fitvids"
14 => "administer google analytics"
15 => "administer languages"
16 => "administer login destination settings"
17 => "administer menu"
18 => "administer modules"
19 => "administer nodes"
20 => "administer pathauto"
21 => "administer permissions"
22 => "administer redirects"
23 => "administer scheduler"
24 => "administer search"
25 => "administer shortcuts"
26 => "administer site configuration"
27 => "administer software updates"
28 => "administer taxonomy"
29 => "administer themes"
30 => "administer url aliases"
31 => "administer users"
32 => "administer views"
33 => "administer xmlsitemap"
34 => "assign all roles"
35 => "bypass node access"
36 => "cancel account"
37 => "change own username"
38 => "create blog content"
39 => "create country content"
40 => "create event content"
41 => "create external_course content"
42 => "create external_event content"
43 => "create form content"
44 => "create front content"
45 => "create group content"
46 => "create member_update content"
47 => "create news content"
48 => "create page content"
49 => "create person content"
50 => "create policy_update content"
51 => "create promo content"
52 => "create publication content"
53 => "create resource content"
54 => "create resource_series content"
55 => "create slide content"
56 => "create system_page content"
57 => "create team content"
58 => "create url aliases"
59 => "create users"
60 => "create voting_form content"
61 => "customize shortcut links"
62 => "delete any blog content"
63 => "delete any country content"
64 => "delete any elearning_module content"
65 => "delete any event content"
66 => "delete any external_course content"
67 => "delete any external_event content"
68 => "delete any form content"
69 => "delete any front content"
70 => "delete any group content"
71 => "delete any member_update content"
72 => "delete any news content"
73 => "delete any page content"
74 => "delete any person content"
75 => "delete any policy_update content"
76 => "delete any promo content"
77 => "delete any publication content"
78 => "delete any resource content"
79 => "delete any resource_series content"
80 => "delete any slide content"
81 => "delete any system_page content"
82 => "delete any team content"
83 => "delete any voting_form content"
84 => "delete any webform content"
85 => "delete own blog content"
86 => "delete own country content"
87 => "delete own elearning_module content"
88 => "delete own event content"
89 => "delete own external_course content"
90 => "delete own external_event content"
91 => "delete own form content"
92 => "delete own front content"
93 => "delete own group content"
94 => "delete own member_update content"
95 => "delete own news content"
96 => "delete own page content"
97 => "delete own person content"
98 => "delete own policy_update content"
99 => "delete own promo content"
100 => "delete own publication content"
101 => "delete own resource content"
102 => "delete own resource_series content"
103 => "delete own slide content"
104 => "delete own system_page content"
105 => "delete own team content"
106 => "delete own user revisions"
107 => "delete own voting_form content"
108 => "delete own webform content"
109 => "edit any blog content"
110 => "edit any country content"
111 => "edit any elearning_module content"
112 => "edit any event content"
113 => "edit any external_course content"
114 => "edit any external_event content"
115 => "edit any form content"
116 => "edit any front content"
117 => "edit any group content"
118 => "edit any member_update content"
119 => "edit any news content"
120 => "edit any page content"
121 => "edit any person content"
122 => "edit any policy_update content"
123 => "edit any promo content"
124 => "edit any publication content"
125 => "edit any resource content"
126 => "edit any resource_series content"
127 => "edit any slide content"
128 => "edit any system_page content"
129 => "edit any team content"
130 => "edit any voting_form content"
131 => "edit any webform content"
132 => "edit own blog content"
133 => "edit own country content"
134 => "edit own elearning_module content"
135 => "edit own event content"
136 => "edit own external_course content"
137 => "edit own external_event content"
138 => "edit own form content"
139 => "edit own front content"
140 => "edit own group content"
141 => "edit own member_update content"
142 => "edit own news content"
143 => "edit own page content"
144 => "edit own person content"
145 => "edit own policy_update content"
146 => "edit own promo content"
147 => "edit own publication content"
148 => "edit own resource content"
149 => "edit own resource_series content"
150 => "edit own slide content"
151 => "edit own system_page content"
152 => "edit own team content"
153 => "edit own voting_form content"
154 => "edit own webform content"
155 => "masquerade as any user"
156 => "masquerade as super user"
157 => "notify of path changes"
158 => "revert own user revisions"
159 => "run security checks"
160 => "schedule publishing of nodes"
161 => "search content"
162 => "select account cancellation method"
163 => "switch shortcut sets"
164 => "switch users"
165 => "use advanced search"
166 => "use text format ds_code"
167 => "use text format filtered_html"
168 => "use text format full_html"
169 => "use text format title"
170 => "view own unpublished content"
171 => "view own user revisions"
172 => "view scheduled content"
173 => "view the administration theme"
]
]
"bundle" => "user_role"
]
5 => array:3 [
"target_id" => "bgs_admin"
"entity" => array:9 [
"uuid" => "66d8f893-6e9e-4d75-817e-01586d8df27e"
"langcode" => "en"
"status" => true
"dependencies" => array:2 [
"config" => array:31 [ …31]
"module" => array:6 [ …6]
]
"id" => "bgs_admin"
"label" => "BGS admin"
"weight" => 30
"is_admin" => null
"permissions" => array:391 [
0 => "access content"
1 => "access content overview"
2 => "access user profiles"
3 => "access users overview"
4 => "administer nodes"
5 => "administer users"
6 => "allow empty user mail"
7 => "bypass paragraphs type content access"
8 => "cancel account"
9 => "cancel users by role"
10 => "change own username"
11 => "create admin_help_page content"
12 => "create blog content"
13 => "create country content"
14 => "create elearning_module content"
15 => "create event content"
16 => "create external_course content"
17 => "create external_event content"
18 => "create external_jobs content"
19 => "create faq content"
20 => "create form content"
21 => "create front content"
22 => "create group content"
23 => "create landing_page content"
24 => "create member_update content"
25 => "create news content"
26 => "create page content"
27 => "create paragraph content attachment"
28 => "create paragraph content attachments"
29 => "create paragraph content block"
30 => "create paragraph content call_to_action"
31 => "create paragraph content faqs"
32 => "create paragraph content faqs_accordion"
33 => "create paragraph content feed"
34 => "create paragraph content form"
35 => "create paragraph content from_library"
36 => "create paragraph content gallery"
37 => "create paragraph content hero_card"
38 => "create paragraph content home_featured_events"
39 => "create paragraph content home_featured_items"
40 => "create paragraph content home_latest"
41 => "create paragraph content iframe"
42 => "create paragraph content link_flexi"
43 => "create paragraph content links"
44 => "create paragraph content links_flexi_container"
45 => "create paragraph content map_world"
46 => "create paragraph content promo"
47 => "create paragraph content q_a"
48 => "create paragraph content quote"
49 => "create paragraph content slider"
50 => "create paragraph content social_links"
51 => "create paragraph content stream_day"
52 => "create paragraph content stream_session"
53 => "create paragraph content tagged"
54 => "create paragraph content team"
55 => "create paragraph content team_member"
56 => "create paragraph content twitter"
57 => "create paragraph content video"
58 => "create paragraph content view"
59 => "create paragraph content wysiwyg"
60 => "create person content"
61 => "create policy_update content"
62 => "create publication content"
63 => "create resource content"
64 => "create resource_series content"
65 => "create simpleads content"
66 => "create slide content"
67 => "create system_page content"
68 => "create team content"
69 => "create users"
70 => "create vimeo_stream content"
71 => "create voting_form content"
72 => "create webform content"
73 => "delete admin_help_page revisions"
74 => "delete any admin_help_page content"
75 => "delete any blog content"
76 => "delete any country content"
77 => "delete any elearning_module content"
78 => "delete any event content"
79 => "delete any external_course content"
80 => "delete any external_event content"
81 => "delete any external_jobs content"
82 => "delete any faq content"
83 => "delete any form content"
84 => "delete any front content"
85 => "delete any group content"
86 => "delete any landing_page content"
87 => "delete any member_update content"
88 => "delete any news content"
89 => "delete any page content"
90 => "delete any person content"
91 => "delete any policy_update content"
92 => "delete any promo content"
93 => "delete any publication content"
94 => "delete any resource content"
95 => "delete any resource_series content"
96 => "delete any simpleads content"
97 => "delete any slide content"
98 => "delete any system_page content"
99 => "delete any team content"
100 => "delete any vimeo_stream content"
101 => "delete any voting_form content"
102 => "delete any webform content"
103 => "delete blog revisions"
104 => "delete country revisions"
105 => "delete elearning_module revisions"
106 => "delete event revisions"
107 => "delete external_course revisions"
108 => "delete external_event revisions"
109 => "delete external_jobs revisions"
110 => "delete faq revisions"
111 => "delete form revisions"
112 => "delete front revisions"
113 => "delete group revisions"
114 => "delete landing_page revisions"
115 => "delete member_update revisions"
116 => "delete news revisions"
117 => "delete own admin_help_page content"
118 => "delete own blog content"
119 => "delete own country content"
120 => "delete own elearning_module content"
121 => "delete own event content"
122 => "delete own external_course content"
123 => "delete own external_event content"
124 => "delete own external_jobs content"
125 => "delete own faq content"
126 => "delete own form content"
127 => "delete own front content"
128 => "delete own group content"
129 => "delete own landing_page content"
130 => "delete own member_update content"
131 => "delete own news content"
132 => "delete own page content"
133 => "delete own person content"
134 => "delete own policy_update content"
135 => "delete own promo content"
136 => "delete own publication content"
137 => "delete own resource content"
138 => "delete own resource_series content"
139 => "delete own simpleads content"
140 => "delete own slide content"
141 => "delete own system_page content"
142 => "delete own team content"
143 => "delete own vimeo_stream content"
144 => "delete own voting_form content"
145 => "delete own webform content"
146 => "delete page revisions"
147 => "delete paragraph content attachment"
148 => "delete paragraph content attachments"
149 => "delete paragraph content block"
150 => "delete paragraph content call_to_action"
151 => "delete paragraph content faqs"
152 => "delete paragraph content faqs_accordion"
153 => "delete paragraph content feed"
154 => "delete paragraph content form"
155 => "delete paragraph content from_library"
156 => "delete paragraph content gallery"
157 => "delete paragraph content hero_card"
158 => "delete paragraph content home_featured_events"
159 => "delete paragraph content home_featured_items"
160 => "delete paragraph content home_latest"
161 => "delete paragraph content iframe"
162 => "delete paragraph content link_flexi"
163 => "delete paragraph content links"
164 => "delete paragraph content links_flexi_container"
165 => "delete paragraph content map_world"
166 => "delete paragraph content promo"
167 => "delete paragraph content q_a"
168 => "delete paragraph content quote"
169 => "delete paragraph content slider"
170 => "delete paragraph content social_links"
171 => "delete paragraph content stream_day"
172 => "delete paragraph content stream_session"
173 => "delete paragraph content tagged"
174 => "delete paragraph content team"
175 => "delete paragraph content team_member"
176 => "delete paragraph content twitter"
177 => "delete paragraph content video"
178 => "delete paragraph content view"
179 => "delete paragraph content wysiwyg"
180 => "delete person revisions"
181 => "delete policy_update revisions"
182 => "delete promo revisions"
183 => "delete publication revisions"
184 => "delete resource revisions"
185 => "delete resource_series revisions"
186 => "delete simpleads revisions"
187 => "delete slide revisions"
188 => "delete system_page revisions"
189 => "delete team revisions"
190 => "delete vimeo_stream revisions"
191 => "delete voting_form revisions"
192 => "delete webform revisions"
193 => "edit any admin_help_page content"
194 => "edit any blog content"
195 => "edit any country content"
196 => "edit any elearning_module content"
197 => "edit any event content"
198 => "edit any external_course content"
199 => "edit any external_event content"
200 => "edit any external_jobs content"
201 => "edit any faq content"
202 => "edit any form content"
203 => "edit any front content"
204 => "edit any group content"
205 => "edit any landing_page content"
206 => "edit any member_update content"
207 => "edit any news content"
208 => "edit any page content"
209 => "edit any person content"
210 => "edit any policy_update content"
211 => "edit any promo content"
212 => "edit any publication content"
213 => "edit any resource content"
214 => "edit any resource_series content"
215 => "edit any simpleads content"
216 => "edit any slide content"
217 => "edit any system_page content"
218 => "edit any team content"
219 => "edit any vimeo_stream content"
220 => "edit any voting_form content"
221 => "edit any webform content"
222 => "edit own admin_help_page content"
223 => "edit own blog content"
224 => "edit own country content"
225 => "edit own elearning_module content"
226 => "edit own event content"
227 => "edit own external_course content"
228 => "edit own external_event content"
229 => "edit own external_jobs content"
230 => "edit own faq content"
231 => "edit own form content"
232 => "edit own front content"
233 => "edit own group content"
234 => "edit own landing_page content"
235 => "edit own member_update content"
236 => "edit own news content"
237 => "edit own page content"
238 => "edit own person content"
239 => "edit own policy_update content"
240 => "edit own promo content"
241 => "edit own publication content"
242 => "edit own resource content"
243 => "edit own resource_series content"
244 => "edit own simpleads content"
245 => "edit own slide content"
246 => "edit own system_page content"
247 => "edit own team content"
248 => "edit own vimeo_stream content"
249 => "edit own voting_form content"
250 => "edit own webform content"
251 => "edit users by role"
252 => "revert admin_help_page revisions"
253 => "revert all revisions"
254 => "revert blog revisions"
255 => "revert country revisions"
256 => "revert elearning_module revisions"
257 => "revert event revisions"
258 => "revert external_course revisions"
259 => "revert external_event revisions"
260 => "revert external_jobs revisions"
261 => "revert faq revisions"
262 => "revert form revisions"
263 => "revert front revisions"
264 => "revert group revisions"
265 => "revert landing_page revisions"
266 => "revert member_update revisions"
267 => "revert news revisions"
268 => "revert page revisions"
269 => "revert person revisions"
270 => "revert policy_update revisions"
271 => "revert promo revisions"
272 => "revert publication revisions"
273 => "revert resource revisions"
274 => "revert resource_series revisions"
275 => "revert simpleads revisions"
276 => "revert slide revisions"
277 => "revert system_page revisions"
278 => "revert team revisions"
279 => "revert vimeo_stream revisions"
280 => "revert voting_form revisions"
281 => "revert webform revisions"
282 => "select account cancellation method"
283 => "update paragraph content attachment"
284 => "update paragraph content attachments"
285 => "update paragraph content block"
286 => "update paragraph content call_to_action"
287 => "update paragraph content faqs"
288 => "update paragraph content faqs_accordion"
289 => "update paragraph content feed"
290 => "update paragraph content form"
291 => "update paragraph content from_library"
292 => "update paragraph content gallery"
293 => "update paragraph content hero_card"
294 => "update paragraph content home_featured_events"
295 => "update paragraph content home_featured_items"
296 => "update paragraph content home_latest"
297 => "update paragraph content iframe"
298 => "update paragraph content link_flexi"
299 => "update paragraph content links"
300 => "update paragraph content links_flexi_container"
301 => "update paragraph content map_world"
302 => "update paragraph content promo"
303 => "update paragraph content q_a"
304 => "update paragraph content quote"
305 => "update paragraph content slider"
306 => "update paragraph content social_links"
307 => "update paragraph content stream_day"
308 => "update paragraph content stream_session"
309 => "update paragraph content tagged"
310 => "update paragraph content team"
311 => "update paragraph content team_member"
312 => "update paragraph content twitter"
313 => "update paragraph content video"
314 => "update paragraph content view"
315 => "update paragraph content wysiwyg"
316 => "use admin toolbar search"
317 => "use editorial transition archive"
318 => "use editorial transition archived_draft"
319 => "use editorial transition archived_published"
320 => "use editorial transition create_new_draft"
321 => "use editorial transition publish"
322 => "use external_event_workflow transition create_new_draft"
323 => "use external_event_workflow transition publish"
324 => "view admin_help_page revisions"
325 => "view all revisions"
326 => "view any unpublished content"
327 => "view blog revisions"
328 => "view country revisions"
329 => "view elearning_module revisions"
330 => "view event revisions"
331 => "view external_course revisions"
332 => "view external_event revisions"
333 => "view external_jobs revisions"
334 => "view faq revisions"
335 => "view form revisions"
336 => "view front revisions"
337 => "view group revisions"
338 => "view landing_page revisions"
339 => "view latest version"
340 => "view member_update revisions"
341 => "view news revisions"
342 => "view own unpublished content"
343 => "view page revisions"
344 => "view paragraph content attachment"
345 => "view paragraph content attachments"
346 => "view paragraph content block"
347 => "view paragraph content call_to_action"
348 => "view paragraph content faqs"
349 => "view paragraph content faqs_accordion"
350 => "view paragraph content feed"
351 => "view paragraph content form"
352 => "view paragraph content from_library"
353 => "view paragraph content gallery"
354 => "view paragraph content hero_card"
355 => "view paragraph content home_featured_events"
356 => "view paragraph content home_featured_items"
357 => "view paragraph content home_latest"
358 => "view paragraph content iframe"
359 => "view paragraph content link_flexi"
…31
]
]
"bundle" => "user_role"
]
]
"default_langcode" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"revision_default" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"revision_translation_affected" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"metatag" => array:3 [
0 => array:2 [
"tag" => "meta"
"attributes" => array:2 [
"name" => "title"
"content" => "publishing | British Geriatrics Society"
]
]
1 => array:2 [
"tag" => "meta"
"attributes" => array:2 [
"name" => "description"
"content" => "British Geriatrics Society"
]
]
2 => array:2 [
"tag" => "link"
"attributes" => array:2 [
"rel" => "canonical"
"href" => "https://d10upgrade.bgs.org.uk/users/amy-brewerton"
]
]
]
"role_change" => array:1 [
0 => array:1 [
"target_id" => "__role_delegation_empty_field_value__"
]
]
"revision_created" => array:1 [
0 => array:1 [
"value" => "1729758232"
]
]
"revision_user" => array:1 [
0 => array:3 [
"target_id" => "595"
"entity" => array:46 [
"uid" => array:1 [ …1]
"uuid" => array:1 [ …1]
"revision_id" => array:1 [ …1]
"langcode" => array:1 [ …1]
"preferred_langcode" => array:1 [ …1]
"preferred_admin_langcode" => []
"name" => array:1 [ …1]
"pass" => array:1 [ …1]
"mail" => array:1 [ …1]
"timezone" => array:1 [ …1]
"status" => array:1 [ …1]
"created" => array:1 [ …1]
"changed" => array:1 [ …1]
"access" => array:1 [ …1]
"login" => array:1 [ …1]
"init" => []
"roles" => array:10 [ …10]
"default_langcode" => array:1 [ …1]
"revision_default" => array:1 [ …1]
"revision_translation_affected" => array:1 [ …1]
"metatag" => array:3 [ …3]
"role_change" => array:1 [ …1]
"revision_created" => array:1 [ …1]
"revision_user" => array:1 [ …1]
"revision_log_message" => []
"path" => array:1 [ …1]
"civicrm_contact_place_of_work" => array:1 [ …1]
"civicrm_contact_region" => array:1 [ …1]
"civicrm_contact_biography" => array:1 [ …1]
"civicrm_contact_prefix" => array:1 [ …1]
"civicrm_contact_job_title" => array:1 [ …1]
"field_blog_subscribers" => array:1 [ …1]
"field_e_bulletin" => array:1 [ …1]
"field_events_e_bulletin_" => array:1 [ …1]
"field_legacy_id" => array:1 [ …1]
"field_member_alert" => []
"field_metatag" => []
"field_national_council_bulletin_" => array:1 [ …1]
"field_nurses_and_ahp_bulletin" => array:1 [ …1]
"field_privacy_statement" => array:1 [ …1]
"field_region_bulletin_" => array:1 [ …1]
"field_sig_and_section_bulletins_" => array:1 [ …1]
"field_special_interest_groups" => array:4 [ …4]
"field_sponsored_e_bulletin" => array:1 [ …1]
"field_trainees_bulletin_" => array:1 [ …1]
"user_picture" => []
]
"bundle" => "user"
]
]
"revision_log_message" => []
"path" => array:1 [
0 => array:3 [
"alias" => "/users/amy-brewerton"
"pid" => "83012"
"langcode" => "en"
]
]
"civicrm_contact_place_of_work" => array:1 [
0 => array:1 [
"#markup" => "British Geriatrics Society"
]
]
"civicrm_contact_region" => array:1 [
0 => array:1 [
"#markup" => "British Geriatrics Society"
]
]
"civicrm_contact_biography" => array:1 [
0 => array:1 [
"#markup" => "Amy"
]
]
"civicrm_contact_prefix" => array:1 [
0 => array:1 [
"#markup" => "1 Amy Brewerton"
]
]
"civicrm_contact_job_title" => array:1 [
0 => array:1 [
"#markup" => "Publications & Website Editor"
]
]
"field_blog_subscribers" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"field_e_bulletin" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"field_events_e_bulletin_" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"field_legacy_id" => array:1 [
0 => array:1 [
"value" => "14122"
]
]
"field_member_alert" => []
"field_metatag" => []
"field_national_council_bulletin_" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"field_nurses_and_ahp_bulletin" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"field_privacy_statement" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"field_region_bulletin_" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"field_sig_and_section_bulletins_" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"field_special_interest_groups" => array:1 [
0 => array:3 [
"target_id" => "7243"
"entity" => array:22 [
"tid" => array:1 [ …1]
"uuid" => array:1 [ …1]
"revision_id" => array:1 [ …1]
"langcode" => array:1 [ …1]
"vid" => array:1 [ …1]
"revision_created" => array:1 [ …1]
"revision_user" => []
"revision_log_message" => []
"status" => array:1 [ …1]
"name" => array:1 [ …1]
"description" => array:1 [ …1]
"weight" => array:1 [ …1]
"parent" => array:1 [ …1]
"changed" => array:1 [ …1]
"default_langcode" => array:1 [ …1]
"revision_default" => array:1 [ …1]
"revision_translation_affected" => array:1 [ …1]
"metatag" => array:2 [ …2]
"path" => array:1 [ …1]
"publish_on" => []
"unpublish_on" => []
"field_civicrm_entity" => []
]
"bundle" => "group"
]
]
"field_sponsored_e_bulletin" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"field_trainees_bulletin_" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"user_picture" => []
]
"bundle" => "user"
]
]
"title" => array:1 [
0 => array:1 [
"value" => "Be proactive: Delivering proactive care - Overview"
]
]
"created" => array:1 [
0 => array:1 [
"value" => "1731407657"
]
]
"changed" => array:1 [
0 => array:1 [
"value" => "1732183104"
]
]
"promote" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"sticky" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"default_langcode" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"revision_default" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"revision_translation_affected" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"moderation_state" => []
"body_class" => []
"specific_node_class" => []
"promote_to_featured_on_home_page" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"metatag" => array:2 [
0 => array:2 [
"tag" => "meta"
"attributes" => array:2 [
"name" => "title"
"content" => "Be proactive: Delivering proactive care - Overview | British Geriatrics Society"
]
]
1 => array:2 [
"tag" => "link"
"attributes" => array:2 [
"rel" => "canonical"
"href" => "https://d10upgrade.bgs.org.uk/resources/be-proactive-delivering-proactive-care-overview"
]
]
]
"path" => array:1 [
0 => array:3 [
"alias" => "/resources/be-proactive-delivering-proactive-care-overview"
"pid" => "132038"
"langcode" => "en"
]
]
"publish_on" => []
"unpublish_on" => []
"menu_link" => []
"bgs_view_sections_postscript" => array:1 [
0 => array:4 [
"#type" => "view"
"#name" => "sections"
"#display_id" => "postscript"
"#embed" => true
]
]
"bgs_view_resource_feedback" => array:1 [
0 => array:3 [
"#type" => "details"
"#title" => Drupal\Core\StringTranslation\TranslatableMarkup {#4079
#string: "Feedback on this resource?"
#arguments: []
#translatedMarkup: null
#options: []
#stringTranslation: Drupal\Core\StringTranslation\TranslationManager {#380
#translators: array:1 [
30 => array:1 [
0 => Drupal\Core\StringTranslation\Translator\CustomStrings {#385
#translations: array:1 [ …1]
#settings: Drupal\Core\Site\Settings {#12 …1}
#_serviceIds: []
#_entityStorages: []
}
]
]
#sortedTranslators: array:1 [
0 => Drupal\Core\StringTranslation\Translator\CustomStrings {#385}
]
#defaultLangcode: "en"
}
}
"form" => array:2 [
"#type" => "webform"
"#webform" => "webform_227"
]
]
]
"bgs_view_resource_series_resource_related" => array:1 [
0 => array:4 [
"#type" => "view"
"#name" => "resource_series"
"#display_id" => "related_auto_manual"
"#embed" => true
]
]
"bgs_view_sections_additional" => array:1 [
0 => array:4 [
"#type" => "view"
"#name" => "sections"
"#display_id" => "additional"
"#embed" => true
]
]
"bgs_view_sections_hero" => array:1 [
0 => array:4 [
"#type" => "view"
"#name" => "sections"
"#display_id" => "hero"
"#embed" => true
]
]
"bgs_view_resource_series_other_resources" => array:1 [
0 => array:4 [
"#type" => "view"
"#name" => "resource_series"
"#display_id" => "other_resources"
"#embed" => true
]
]
"bgs_view_sections_main" => array:1 [
0 => array:4 [
"#type" => "view"
"#name" => "sections"
"#display_id" => "main"
"#embed" => true
]
]
"field_body" => []
"field_clinical_research_type" => []
"field_date" => array:1 [
0 => array:1 [
"value" => "2024-11-14"
]
]
"field_date_display_override" => []
"field_date_updated" => array:1 [
0 => array:1 [
"value" => "2024-11-14T10:30:00"
]
]
"field_feedback_form" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"field_full_title" => array:1 [
0 => array:1 [
"value" => "Be proactive: Delivering proactive care - Overview"
]
]
"field_group" => array:2 [
0 => array:3 [
"target_id" => "7276"
"entity" => array:22 [
"tid" => array:1 [
0 => array:1 [
"value" => "7276"
]
]
"uuid" => array:1 [
0 => array:1 [
"value" => "93d57776-be64-4488-90c6-dd1a781bacb6"
]
]
"revision_id" => array:1 [
0 => array:1 [
"value" => "7276"
]
]
"langcode" => array:1 [
0 => array:1 [
"value" => "en"
]
]
"vid" => array:1 [
0 => array:3 [
"target_id" => "group"
"message" => "Recursion detected."
"array_path" => "uid.0.entity.revision_user.0.entity.field_special_interest_groups.0.entity.vid.0.entity"
]
]
"revision_created" => array:1 [
0 => array:1 [
"value" => "1712220738"
]
]
"revision_user" => []
"revision_log_message" => []
"status" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"name" => array:1 [
0 => array:1 [
"value" => "Nurse and AHP Council"
]
]
"description" => array:1 [
0 => array:2 [
"value" => null
"format" => null
]
]
"weight" => array:1 [
0 => array:1 [
"value" => "0"
]
]
"parent" => array:1 [
0 => array:1 [
"target_id" => "0"
]
]
"changed" => array:1 [
0 => array:1 [
"value" => "1712220738"
]
]
"default_langcode" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"revision_default" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"revision_translation_affected" => array:1 [
0 => array:1 [
"value" => "1"
]
]
"metatag" => array:2 [
0 => array:2 [
"tag" => "meta"
"attributes" => array:2 [
"name" => "title"
"content" => "Nurse and AHP Council | British Geriatrics Society"
]
]
1 => array:2 [
"tag" => "link"
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\t\t\t<td>\r\n
\t\t\t\t<h2 class="sidebar-nav">Foreword</h2>\r\n
\r\n
\t\t\t\t<p class="larger-text">Proactive care plays a vital role in delaying the onset of frailty, maintaining older people’s independence, and reducing avoidable periods of ill health. Last year, the BGS highlighted the importance of proactive care in <a href="https://www.bgs.org.uk/Blueprint">Joining the Dots: A blueprint for preventing and managing frailty in older people</a> by highlighting it as one of seven key touchpoints to support older people to age well. </p>\r\n
\r\n
\t\t\t\t<p>We were pleased that the long-awaited <a href="https://www.england.nhs.uk/long-read/proactive-care-providing-care-and-support-for-people-living-at-home-with-moderate-or-severe-frailty">NHS England Guidance on proactive care </a>was published last year. Previously known as anticipatory care, proactive care is one of the three original streams of the Ageing Well programme, as detailed in the <a href="https://www.england.nhs.uk/publication/the-nhs-long-term-plan/">NHS Long Term Plan</a>. While we remain disappointed that the initial promised funding for the programme was cut, the guidance provides a crucial framework. </p>\r\n
\r\n
\t\t\t\t<p>In October 2024, the BGS published <a href="/ProactiveCareEvidence"><em>Be proactive: Evidence supporting proactive care for older people with frailty</em></a>. This first publication provides evidence to help colleagues build business cases for proactive care in their locality. Our second publication, <em>Be proactive: Delivering care for older people with frailty</em>, acts as a roadmap to support the delivery of proactive care services for older people with moderate to severe frailty. With the NHS England guidance as an overarching framework, we propose colleagues use both BGS documents to deliver evidence-based proactive care. </p>\r\n
\r\n
\t\t\t\t<p>To deliver proactive care, we recognise colleagues require both appropriate infrastructure and policy locally and nationally. As such, our second report provides eight recommendations requiring action from commissioners, policymakers, providers and healthcare professionals at local, regional and national levels. We urge anyone involved in commissioning proactive care services to seek the expertise and resources available from the BGS. </p>\r\n
\r\n
\t\t\t\t<p>We know that the provision of proactive care services varies greatly across the UK, creating unequal health outcomes for older people. However, we also know there are many exemplary proactive care services across the four nations, and we believe the same principles apply to the organisation and delivery of proactive care across the UK. As with all our work at the BGS, we have been pleased to work with our multidisciplinary members who provided invaluable insights and content to inform the report. I would like to thank all those involved. Now, it is crucial that proactive care is prioritised and embedded across all primary and community settings to ensure older people live well and stay independent for longer.</p>\r\n
\r\n
\t\t\t\t<p style="text-align: center;"><br />\r\n
\t\t\t\t\t<strong>Professor Jugdeep Dhesi</strong><br />\r\n
\t\t\t\t\tBGS President Elect </p>\r\n
\t\t\t</td>\r\n
\t\t</tr>\r\n
\t</tbody>\r\n
</table>\r\n
\r\n
<h2 class="sidebar-nav">Executive summary</h2>\r\n
\r\n
<p class="larger-text">Frailty is common in older people, affecting more than one in ten people over 65 living in the community<sup>1</sup> and up to half of the total UK population over 85.<sup>2</sup> As the UK population continues to age, these figures are expected to increase and likely to double by 2045 with associated implications for healthcare systems.<sup>1</sup> Despite this, frailty is not an inevitable part of ageing. </p>\r\n
\r\n
<p>As outlined in BGS’s <em><a href="/Blueprint">Joining the dots: A blueprint for preventing and managing frailty in older people</a></em>, older people need a comprehensive ‘wrap around’ health and social care system that supports healthy ageing and maximises functional independence.<sup>1</sup> To achieve this, the blueprint sets out seven system touchpoints that should be included when planning and commissioning health and social care for older people. </p>\r\n
\r\n
<p>One of these vital touchpoints is ‘population-based proactive anticipatory care’, which identifies older people at risk of ill health and poor outcomes and offers them personalised interventions to remain well for longer. This publication will explore this touch point in further depth, focussing on proactive care for older people with moderate to severe frailty receiving care in community and primary care settings. The document is aimed at healthcare professionals, clinical leaders, policy makers, and commissioners and acts as a roadmap for delivering proactive care for older people with frailty. </p>\r\n
\r\n
<p>Building on the recent NHS England proactive care guidance, <a href="https://www.england.nhs.uk/long-read/proactive-care-providing-care-and-support-for-people-living-at-home-with-moderate-or-severe-frailty/"><em>Proactive care: providing care and support for people living at home with moderate or severe frailty</em></a>,<sup>2</sup> this publication outlines how to deliver proactive care against the five NHS core components and three key enablers. It also outlines eight key recommendations for the successful implementation of proactive care services across the UK. It will complement BGS’s <a href="https://www.bgs.org.uk/ProactiveCareEvidence"><em>Be proactive: Evidence supporting proactive care for older people with frailty</em></a>,<sup>3</sup> which outlines the evidence base for proactive care. Users will be able to utilise all three documents when designing proactive care services, with the NHS England guidance document acting as key framework and starting point, BGS’s evidence document as a business case, and this document as roadmap for implementing the NHS England framework and delivering services. </p>\r\n
\r\n
<h2 class="sidebar-nav">Core components </h2>\r\n
\r\n
<h5>Case identification</h5>\r\n
\r\n
<p>A wide range of different approaches can be used to identify people that may benefit from proactive care services. This includes using human knowledge; analysing admission, discharge and caseload data; receiving referrals; and using algorithms to identify people from databases. The electronic frailty index (eFI) is a tool that uses data from a patient’s electronic health record to identify and grade the severity of frailty and can be used alongside other criteria to identify a cohort. Once identified, tools such as the Clinical Frailty Scale (CFS) can be used to confirm diagnosis. </p>\r\n
\r\n
<h5>Holistic assessment</h5>\r\n
\r\n
<p>Once a patient has been identified, a holistic assessment, such as a Comprehensive Geriatric Assessment (CGA), should be used to assess their needs. The assessment should include physical, functional, social, environmental, and psychological assessments, alongside a medication review. The Geriatric 5Ms framework can be used as a framework for holistic assessments, focusing on mind, mobility, medication, multicomplexity, and what matters most to patients.<sup>4</sup></p>\r\n
\r\n
<h5>Personalised care and support planning </h5>\r\n
\r\n
<p>Following on from holistic assessments, individuals should be supported with a personalised care and support plan. Proactive care services should develop a format for care planning, focussing on falls prevention, nutrition advice, social care support, medication reviews, advanced care planning, and emergency care plans, such as ReSPECT forms. Plans should include preventative strategies to address common issues associated with frailty, including vaccinations, regular screening, and proactive management of chronic conditions. </p>\r\n
\r\n
<h5>Co-ordinated and multi-professional working </h5>\r\n
\r\n
<p>At a minimum, the core proactive care team should consist of a GP with an interest in frailty, an Advanced Clinical Practitioner, and a Care Co-ordinator. If resource is available, the core team can extend to include professionals from mental health services, pharmacy, social care, therapy and Geriatric Medicine. Effective communications should be implemented, such as a regular multidisciplinary team (MDT) meeting, and sufficient training and development opportunities available. </p>\r\n
\r\n
<h5>Continuity of care </h5>\r\n
\r\n
<p>Continuity of care is essential to ensure that proactive care interventions are being implemented. The core proactive care team should liaise with service providers and the relevant members of the multidisciplinary team to ensure that proactive care is being delivered. Frailty is not a static process and therefore follow up is needed to see how the patient’s condition has changed over time. </p>\r\n
\r\n
<h2 class="sidebar-nav">Key enablers </h2>\r\n
\r\n
<h5>Flexible workforce </h5>\r\n
\r\n
<p>It is important that the multidisciplinary proactive care team is supported to work across organisational boundaries, with sufficient capacity and training opportunities. The team should have an understanding of frailty and associated issues such as falls, immobility, delirium, incontinence, multi morbidity, and polypharmacy. A shared workforce plan across the partner organisations outlining ways of working and training opportunities for staff should be developed. </p>\r\n
\r\n
<h5>Shared care record</h5>\r\n
\r\n
<p>Information sharing is vital for proactive care services as it requires multidisciplinary interventions across a range of health and care organisations. It is important that the core proactive team has access to all electronic patient records, including general practice, community services, hospitals and social care. If this is not possible, they should have access to all the shared records available in the area. </p>\r\n
\r\n
<h5>Clear accountability and shared decision-making</h5>\r\n
\r\n
<p>Shared decision-making and governance between provider organisations are essential to the success of proactive care services. When designing the service, local leaders should agree on the aim of the service and develop shared values. Holistic care often consists of many overlapping services such as physical health, mental health, psychological services and social services as well as community and voluntary care services. </p>\r\n
\r\n
<p>It is important that all these services work from shared values focussed on what matters most to the patient. Data collection and outcome measure should also be considered when designing the service. Services should consider using patient reported outcomes or functional measures, such as Activities of Daily Living (ADLs) and patient experience measures. As outcome measures for proactive care are difficult to implement, process measures may provide another approach to demonstrate the value of an intervention.</p>\r\n
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\t\t\t\t<h2 class="sidebar-nav">Recommendations for delivering proactive care</h2>\r\n
\r\n
\t\t\t\t<h6 class="larger-text">Recommendation 1</h6>\r\n
\r\n
\t\t\t\t<p style="margin-left: 40px;">Proactive care services should be aligned to the approximate geography of a Primary Care Network (PCN)/Primary Care Cluster (PCC) or equivalent, with a dedicated proactive care team in each equivalent area across the UK. </p>\r\n
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\t\t\t\t<h6>Recommendation 2</h6>\r\n
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\t\t\t\t<p style="margin-left: 40px;">Policy makers and commissioners should prioritise national funding and contractual arrangements to ensure that proactive care is available to all older people living with frailty in the community. </p>\r\n
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\t\t\t\t<h6>Recommendation 3</h6>\r\n
\r\n
\t\t\t\t<p style="margin-left: 40px;">Leadership is vital to the delivery of successful proactive care services, and it should be supported and nurtured through training opportunities and protected funding. </p>\r\n
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\t\t\t\t<h6>Recommendation 4</h6>\r\n
\r\n
\t\t\t\t<p style="margin-left: 40px;">Outcome measures are vital in evaluating the success of proactive care interventions and should always be implemented when new services are launched. National guidance on how to measure the impact of proactive care interventions should be published, and investment is needed in clinical research and IT infrastructure focussed on data collection and evaluation. </p>\r\n
\r\n
\t\t\t\t<h6>Recommendation 5</h6>\r\n
\r\n
\t\t\t\t<p style="margin-left: 40px;">Proactive care services should be staffed by a core multidisciplinary team, consisting of at least one GP with an interest in frailty, one Advanced Clinical Pratitioner, and one Care Co-ordinator. A gold standard team would include professionals from social care, mental health services, therapies, pharmacy and geriatric medicine. </p>\r\n
\r\n
\t\t\t\t<h6>Recommendation 6</h6>\r\n
\r\n
\t\t\t\t<p style="margin-left: 40px;">Local and national investment in training and development opportunities for the multidisciplinary team working in proactive care is needed, including mandatory frailty training, training in communication, leadership, and coaching, and education on the wider health and care system. </p>\r\n
\r\n
\t\t\t\t<h6>Recommendation 7</h6>\r\n
\r\n
\t\t\t\t<p style="margin-left: 40px;">A culture of flexible and cross organisational working should be embedded in proactive care services, which requires good working relationships across services. A shared proactive care workforce plan across the partner organisations in each PCN/PCC or equivalent should be developed. </p>\r\n
\r\n
\t\t\t\t<h6>Recommendation 8</h6>\r\n
\r\n
\t\t\t\t<p style="margin-left: 40px;">Services across the UK should use BGS’s <a href="/ProactiveCareEvidence"><em>Be proactive: Evidence supporting proactive care for older people with frailty</em></a><sup>3</sup> to make the case for proactive care services in their local area, and use <em>Be proactive: Delivering proactive care for older people with frailty</em> as a roadmap for implementing services. <em>(Refer to <a href="https://www.bgs.org.uk/resources/be-proactive-delivering-proactive-care-chapter-four-conclusions-appendices-references#anchor-nav-appendix-2-roadmap-for-setting-up-a-proactive-care-service">Appendix 2 </a>for a diagram outlining this roadmap).</em></p>\r\n
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<p class="larger-text">These BGS publications outline evidence and delivery recommendations for proactive care and support for older adults with moderate to severe frailty. </p>\r\n
\r\n
<p>We set out how to deliver proactive care against core components and key enablers, with recommendations for success of a proactive care service. Building on NHS England's proactive care guidance, <strong><a href="https://www.england.nhs.uk/long-read/proactive-care-providing-care-and-support-for-people-living-at-home-with-moderate-or-severe-frailty"><em>Proactive care: providing care and support for people living at home with moderate or severe frailty</em></a></strong>, we also outline key recommendations for the successful implementation of proactive care services across the UK. </p>\r\n
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<p>We hope that users will be able to use all three documents when designing proactive care services, with the NHS England guidance document acting as key framework and starting point, BGS’s <a href="/ProactiveCareEvidence"><strong><em>Be proactive: Evidence supporting proactive care for older people with frailty</em></strong></a> as a business case, and <a href="/resources/be-proactive-delivering-proactive-care-overview"><em><strong>Be proactive: Delivering proactive care for older people with frailty </strong></em></a>as a roadmap for implementing the NHS England framework and delivering services.</p>\r\n
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\r\n
<table border="1" cellpadding="1" cellspacing="1" style="width:500px;">\r\n
\t<tbody>\r\n
\t\t<tr>\r\n
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\t\t</tr>\r\n
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\t\t\t<td>Download <strong><a href="https://www.bgs.org.uk/sites/default/files/content/attachment/2024-11-13/Be%20proactive%20-%20Delivering%20proactive%20care%20for%20older%20people%20with%20frailty.pdf"><em>Be proactive: Delivering proactive care for older people with frailty</em> </a></strong>in<strong> </strong>PDF format.</td>\r\n
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