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Celebrating older people – Professor John Young and Jagtar Dhanda

Older People’s Day is a fantastic opportunity to shine a light on the contribution that older people make to our economy and to wider society. For our health and social care sectors, older people play a critical role – there are over a million older people over the age of 65 who are carers, without whom our health services would simply not be able to cope.

Today’s Older People’s Day comes at a time when the number of people living with cancer is increasing – over the last couple of years our lifetime risk has been revised to an estimated 1 in 2 whereas it in the 1990s it was 1 in 3. This is largely due to our ageing population as well as improvements in cancer treatment meaning more people are living longer and surviving.

Even now, one third of cancer diagnoses are in people aged over 75, with half of deaths occurring in this age group and although we have improved our performance on cancer survival, we still lag behind most of our European neighbours. This deficit is driven largely by the poor survival rates amongst older people.

The care of older people – who often have a number of long-term conditions or frailty – is a fundamental part of the jobs of most staff working in health and care. If we wish to prevent thousands of unnecessary deaths, we must ensure that older people are getting access to the right treatment. Currently, we know that older people are less likely than younger people to receive potentially curative cancer treatments like surgery and chemotherapy. Although there are legitimate health reasons why some older people do not receive treatment, this alone cannot explain the disparity in access.

Research funded by Macmillan Cancer Support tells us that in general, regardless of their age, older people still want to go through with treatment, so we must do more to ensure that clinical teams can provide tailored treatment that delivers the outcomes that matter most to older people.

The recently published ‘Achieving world-class cancer outcomes – A strategy for England 2015-2020‘ gives us an unprecedented opportunity to do this. One of its key recommendations is to develop and test a method of making sure that treatment decisions are enabled by a more rigorous set of assessments. In order to help with designing this method, Macmillan has convened an Expert Reference Group for Geriatric Oncology which brings together older patients with a range of health professionals and is chaired by Professor John Young, NHS England’s National Clinical Director for Integration and Frail Elderly.

Alongside this work, we also need to ensure the wider cancer workforce is equipped to meet the needs of an ageing population, ensuring that it has the training, capability and skill-mix to deliver the best care and treatment.

Older people often have more complex needs but this cannot be used as an explanation, or indeed an excuse, for poor survival. We need to ensure that we have cancer services that are fit for the future – and that means services that are equipped to meet the needs of the population they serve, a large proportion of which will be older people.

  • Professor John Young, National Clinical Director for Integration and Frail & Elderly Care, NHS England
  • Jagtar Dhanda, Head of Inclusion, Macmillan Cancer Support

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