Author Archives: rutheisden

Beating Breast Cancer: several reasons to celebrate

Sometimes in life it’s really important to take a step back and make sure we appreciate the good news stories as well as highlight where things have gone wrong. With that in mind, reports this week of a 100-year-old woman successfully beating breast cancer after undergoing surgery is definitely something to celebrate.

The cause for celebration is not just that Mrs Affleck is recovering well after her operation (a wonderful outcome and we wish her very well indeed) it’s that her medical team seem to have done everything right. This might seem a very obvious and somewhat patronising statement on the face of it. What else would we expect from a professional medical team? But equally, given what we know about age discrimination in treatment and care, I think it does warrant a moment to reflect. Not every story has such a happy outcome.

Stories of age discrimination in health care are unfortunately all too common. Cancer care in particular has come in for serious criticism in the past few years. As data sets have improved, meaning we know more and more about people diagnosed and treated for cancer, it has become increasingly apparent that older people are losing out.

Recent evidence suggests that cancers are more likely to be diagnosed late and patients are less likely to be offered a full range of treatment. Admittedly more work is needed to fully understand why this happens, but age appears to be the overriding factor.

Clinicians are making assumptions about medical health based on preconceptions about age rather than actual health status. Indeed in her statement Mrs Affleck points out that she was left frightened by the prospect of a painful death as she’d been told no one would operate on someone her age.

Luckily in this case her surgeon decided to take another view, assessing her as being in good enough health and, even more importantly, taking into account Mrs Affleck’s own views about what was right for her.

There are all sorts of things to take into account when deciding on the right course of treatment, including someone’s general health and fitness, the impact it might have on other conditions and medications and people’s own preferences and choices. However the number of candles on the person’s last birthday cake is not one of them.

Full statements by Mrs Affleck and her surgeon are available on the BBC website: http://www.bbc.co.uk/news/uk-england-manchester-14732945

Age UK launches Dignity in Care Partnership

Looking back over the years, there has been no shortage of reports, inquiries and commissions examining instances where older people have failed to receive proper dignity of care. The Health Ombudsman report earlier this year, for example, provided a catalogue of appalling examples of  patients who had their basic needs neglected, becoming malnourished and dehydrated, being left in pain, or receiving inadequate assistance with toileting and personal care.  This report made the severity and scale of the problem we are facing crystal clear.

But what has, we believe, been missing up to now is an indepth look at how we as a sector make the changes to ensure that no older person in future needs to endure degrading or undignified care. The  new Dignity in Care Partnership, launching today at Age UK’s Improving Essential Care in Hospital event is about moving on to the next stage and working out what we need to do as a sector to make progress on this problem at a grassroots level.  This initiative brings together the NHS Confederation, Local Government Group and Age UK to work in close collaboration with professionals and healthcare leaders to improve dignity in care.

We know policy at a national level, such as the National Service Framework and guidance from the Royal Colleges, has clearly focused on meeting aspirations of older people, improving the care provided and generally moving things in the right direction.  Yet this guidance is not always consistently transferred into practice on the ground and we need to know why.

To do this, we must ask some difficult questions and shine a light into awkward corners of this thorny issue. What are the root cases of the failure to provide appropriate levels of care to older people? We also need to hear what, as the largest group of users of the health service, are the aspirations of older people and their families in terms of care provided.

The Dignity in Care Partnership is starting out by establishing a commission to examine some of these issues. However, we are clear that this is just a first step. After answers we need action.

I cannot pretend this will be an easy process: we need an honest, warts and all approach if this process is to be effective.  But it isn’t about pointing the finger at the health and care sector, health professionals or individuals. Instead, to deliver real and lasting improvements,  it is vitally important that everyone comes together to discuss how to address practical problems, tackle barriers and change the way we view caring for older people. Patients, professionals and providers must reach a consensus on the underpinning causes of poor care and ‘own’ responsibility for improving their experiences at every level. We also need to establish what really works by identifying good practice examples across the health and social care system.

Everyone can play their part: we are calling for written evidence via the NHS Confederation website and will also be carrying out a series of oral hearings to collectively develop a series of recommendations to be published in a report in Spring 2012.  Another report it may be, but I believe it has the capacity to start the journey towards making dignity in care a reality for every older person.

NHS listening exercise: patients have their say

Age UK is co- hosting a listening event on Thursday 19th May to enable older patients to put their views to Government on NHS modernisation and the Health and Social Care Bill.

At the beginning of April the Coalition Government announced that it would be ‘pausing’ progress of the Health and Social Care Bill to embark on a listening exercise. Since then NHS reform has been on hold awaiting the recommendations of the Future Forum, a group appointed by Government to review their proposals and make recommendations to improve the legislation. Members of the Future Forum and Ministers have spent much of the last 6 weeks travelling the country listening to people’s concerns. This week it’s the turn of service users and carers to make their voices heard. On Thursday Age UK will co-host an event with ten other leading health charities giving Minsters and Future Forum members the opportunity to hear directly from older patients about their views on NHS reform.

The NHS is one of the most prized institutions in Britain today – and for very good reason. For nearly 65 years the NHS has delivered comprehensive healthcare, essentially free at the point of delivery, to anyone in need. While both science and society have changed enormously since 1948 – and with it our expectations and aspirations – these core principles remain hugely important to the British public. The Health and Social Care Bill represents the most fundamental reorganisation of the NHS since it started. It is hardly surprising then that the proposals have sparked huge public debate.

As the debate around reform has intensified it has become increasingly focused on one issue in particular; whether reform is necessary to make sure the NHS is equipped to meet the needs of a growing older population. And, if so, whether this particular package of reform is the right one?  Continue reading