A report by the Royal College of Surgeons and Age UK has warned that age discrimination in the NHS may still be preventing older people from having access to life-saving surgery.
An analysis of surgery rates across England’s 211 Clinical Commissioning Groups (CCGs), for six common procedures, which are known to be effective in older people, showed widespread variation in the rates of surgery for people aged over 65 and 75, depending on where they live.
Operations for procedures to remove cancers of the breast and colon can be life-saving; while surgery to replace a hip, or repair a hernia, has the potential to transform a person’s life by alleviating pain, allowing them to regain their mobility and independence and by relieving stress.
However, the study found that a number of CCGs have very few people in the over 75 age group who have received surgery for the procedures analysed. It warns that almost onefifth of CCGs recorded a decline of more than 25% in at least three procedures between patients aged over 65 and over 75.
The report, Access All Ages 2: variations in access to surgical treatment among older people, adds to information from a previous study, published by the Royal College of Surgeons and Age UK in October 2012, which first raised the issue of whether a person’s age restricted their access to surgery.
The president of the Royal College of Surgeons, Professor Norman Williams, said: “This report raises important questions about how we treat older people on the NHS and whether they have access to the type of surgery they need. Every patient must be treated as an individual and, when a decision is made about their treatment, they must be judged according to their physiological age – how healthy they are – rather than their chronological age.”
Commenting on the report, Caroline Abrahams, charity director at Age UK, said: “Treatment of older people must be based on their needs and a true picture of their health, not just their age. This report raises serious questions about how local areas support older people accessing surgery. Whether it’s referral practices, decision-making around treatment or how well older people are supported to remain resilient in the face of surgery, the extent of variation suggests many places could be doing better.
“Out-dated assumptions about fitness, based on age alone, have no place in decisions around surgery. For local areas to achieve the best possible outcomes they must assess older people’s overall state of health, support them to manage any complications resulting from living with a long-term condition and take steps so that they are in the best possible health at the time they undergo surgery. We must consign age discrimination to the past.”
