NHS cuts ‘putting older patients at risk of age discrimination’

According to the “Access all Ages” report from the Royal College of Surgeons and Age UK, published today, surgery rates decline for people as they grow older for treatments including cancer operations, joint replacements and hernias.

While the incidence of breast cancer peaks in patients aged over 85, surgery rates decline sharply from the age of 70, the figures indicate.

Pensioners are the main group to receive hip and knee replacements but the rates of surgery in England dropped sharply in patients over 70, according to the data which examines operations between 2008 and 2011.

The research also found the number of patients who receive treatment for prostate cancer plummets after they reach 70.

The Royal College of Surgeons said that surgeons should no longer look at a patient’s age to assume whether they are suitable for surgery but, instead, their overall health should be taken into consideration.

Michelle Mitchell, charity director general of Age UK, said “When it comes to people’s health, their date of birth actually tells you very little.

“A healthy living 80-year-old could run rings round someone many years younger who does not share the same good health.

“Yet in the past, too many medical decisions we believe have been made on age alone, with informal cut-offs imposed so that people over a certain age were denied treatment.”

The authors of the report said there are a number of possible explanations as to why older people are not getting life-saving treatment.

Doctors are looking at people’s age to assess whether they are suitable for treatment, instead of their overall wellbeing and fitness, they said.

The NHS £20bn efficiency drive also puts older patients at a “heightened risk” of age discrimination because restrictions may be imposed when healthcare workers balance the cost of treatment against the patient’s life expectancy, they claimed.

Professor Norman Williams, president of the Royal College of Surgeons, said: “There are multiple factors that affect treatment decisions and often valid explanations as to why older people either opt out of surgery – or are recommended non-surgical treatment alternatives.

“The key is that it is a decision based on the patient rather than how old they are that matters.”

The authors have made a series of recommendations to ensure that older people have fair access to surgery, including ensuring there are no age “cut offs” which would see older patients denied treatment.

Junior doctors should receive dedicated training for the care of elderly patients and communication with patients to discuss the risks and benefits of surgery must also improve, they said.

They also suggest that disease awareness campaigns should be created to make older people more aware of illnesses.

The report comes after new legislation prevents age discrimination within the health service.

If a patient is denied drugs or treatment on the grounds of age they can now take legal action against healthcare providers.

NHS Confederation chief executive Mike Farrar said: “Age discrimination is not only illegal but goes against all the principles and values of the NHS.

“We know that prejudicial attitudes against older people still pervade through society but the NHS and its staff should close the door to such unacceptable behaviour.”