Assumptions about fitness in older people should not be used to decide whether patients have surgery, according to a report by the Royal College of Surgeons and Age UK.
The report says that when budgets are tight, some older patients miss out on vital treatment because of their age despite age discrimination in the NHS has been made illegal; age discrimination by NHS hospitals was outlawed at the beginning of October in a decision that applied across England, Wales and Scotland. Patients will be able to sue if they are denied care solely because of their age.
When normally doctors should look at the overall health of a patient instead of using cut-off ages for procedures, some doctors may have “outdated perceptions” and a “lack of awareness” about older patients and their ability to cope with surgery.
The report, Access All Ages, points out that there are valid reasons why an older patient might not be considered for surgery – because they have other health problems that increase the risk of operations, or that they themselves prefer not to go under the knife.
However, the report said:
While there may be legitimate clinical reasons why an older person may not benefit from surgery, it remains the case that some patients may be missing out.
Decisions may not always be made on the basis of a comprehensive and objective assessment, but on a series of assumptions about fitness in older age.
The report highlighted rates of breast cancer, which are at their highest in women above the age of 85. However, the highest surgery rate was in women two decades younger.
Michelle Mitchell, from 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 literally 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 NHS Confederation's chief executive Mike Farrar said:
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.