Advice line: physios need to fight for appropriate care for older people

When the NHS was created almost 70 years ago, it promised to deliver health care to all, based on need, rather than the ability to pay. The NHS has developed greatly since its inception, and the common belief remains: the NHS is one of the fairest health systems in the world.

 

It may, then, come as a surprise to hear that the UK has some of the worst cancer survival rates for older people in Europe.  Shockingly, it is estimated that more than 14,000 cancer deaths in the over-75s could be avoided each year in the UK, if mortality rates were the same as those in the USA.

 

There is a growing body of evidence to suggest that older people with cancer are under treated. This may explain why, while mortality rates are improving significantly for the under-75s, they are improving at a much slower rate in those aged 74-84 and actually getting worse for those aged 85 and over. 

 

Cancer is predominantly a disease of age. Half of those people newly diagnosed in the UK are over 70, so why is the NHS undertreating this population? The reasons appear to be multifactorial: poor assessment methods; a lack of practical support for the patient; and deficiencies in joined up working between specialists, primary and social care. 

 

So what can be done?  Physiotherapists are well placed to challenge health inequalities, and provide effective management to improve the quality of life for older people with cancer. 

 

Treatment options should be based on fitness and determined by methods of clinical assessment, not merely chosen because of the chronological age of the patient.

 

With the right treatment, over-65s can survive for many years after being diagnosed with a cancer. As physiotherapists, let’s push for equality, support our older patients in getting treatment that is appropriate and effective, and fight age being a decision-making point.