NEWS
Age should not close the door to surgery
Decisions on whether older people are put forward for surgery must not be based on assumptions of age and fitness, warns a new report from the Royal College of Surgeons (RCS) and Age UK. It says that age should no longer be used as a shortcut to assessing suitability for treatment. Instead a person’s overall health – or ‘biological age’ – should be the main consideration, says the report. The report identified that even though a
patient’s health needs – including conditions that could be treated by surgery – increases with age, elective surgery rates decline steadily for people as they grow older. Therefore, the gap between the increasing health need and access to surgery means that many older people could be missing out on potentially life-saving treatment. The study, Access all Ages: Assessing the
impact of age on access to surgical treatment, examines the patterns of surgical treatment in relation to age across eight areas of surgery. The study also warns that the £20 bn NHS
efficiency drive heightens the danger of older people being disproportionately impacted, as restrictions may be imposed because of the perceived reduction in the cost effectiveness of
providing treatment when relative life expectancy is shorter. It highlights that a new ban on age discrimination in the NHS came into effect at the beginning of this month, providing a legal framework to go alongside moral and professional imperatives to ensure that older patients receive the most appropriate treatment for their individual needs whatever their date of birth.
The report does, however, acknowledge that
not everyone will benefit from surgery and there are legitimate reasons why older people may decide with their clinician not to go ahead with a procedure. However, it also questions the way the NHS has approached the care of older people, saying it has has failed to keep pace with advances in medical and social care which have resulted in people living longer healthier lives. The report found that:
• The incidence of breast cancer peaks in the 85+ age group, while the surgery rate peaks for patients in their mid-60s and then declines sharply from the age of 70.
• People over the age of 65 make up the majority of recipients of joint replacement surgery. However, the rate of elective knee
Financialpressures hit training
Financial pressures are taking their toll on medical training, a new junior doctor leader has warned. Dr Ben Molyneux, a general practice trainee in London, was elected as the new chair of the BMA’s Junior Doctors Committee. Dr Molyneux has signalled that
safeguarding the quality of training will be a key priority for the year ahead: “The economic climate in the NHS, coupled with major changes introduced by the Health and Social Care Act, has created a perfect storm for the potential erosion of high quality medical training.We have already seen evidence that the financial pressures are taking their toll on
medical training. In the south of England some trainees have been forced to complete two placements in psychiatry because the Trust is short staffed. Junior doctors should not be denied a rounded training programme which exposes them to a range of specialties. “A recent survey showed that half of those
questioned were more likely to leave the NHS to work overseas after training compared to two years ago. This would represent a massive potential loss to the NHS. Continued pay freezes and the raid on doctors’ pensions will further demoralise a profession who face an intense and lengthy training programme.”
STOP – holes, rips and tears with STOPPER®
• Prevents holes, rips and tears in sterilisation wrap from heavy and sharp corner trays.
• Does not retain moisture.
• Eliminates “bottoming out"; flatten when placed under heavytrays.
• Recycleable, environmentally friendly. • Natural colour – no dyes in product. • Low cost, very economical to use.
NOVEMBER 2012 500/CS – NON STERILE THE CLINICAL SERVICES JOURNAL 9
Mixed-sex accommodation breaches at a record low
Mixed-sex accommodation breaches for hospitals in England have fallen by 99% since monitoring started almost two years ago, according to data published by the Department of Health. In August 2012 there were only 160
breaches – occasions where patients were unjustifiably placed in mixed-sex accommodation – down from 11,802 in December 2010 when the data was first collected. The numbers have fallen for the fourth month in a row, down 36% from 249 in July 2012. A total of 136 Trusts (84%) reported zero
breaches. The most significant reductions in breaches were recorded at King’s College Foundation Trust (55 to 15), South London Healthcare (22 to 3), and Royal Surrey County Hospital (10 to 0).
replacement and hip replacement surgery for patients in their late 70s and over has dropped sharply and consistently over the three years examined.
• Around 10,000 men a year die from prostate cancer and the incidence of the disease increases with age. Overall, half of men who develop the disease will die as a direct result of it. Again, surgical treatment rates for the disease do not match the number of new cases being diagnosed among the older population.
• Emergency surgical procedures are increasing for hernias in older people, while the planned surgery rates plummet once a patient passes the 75-79 bracket.
The report recommends that all those with an interest in improving health outcomes must work together to safely optimise surgery rates for older people. It urges clinicians to inform patients if surgery has been ruled out for a condition where it would normally be considered and provide reasons. The report concludes that there should be no informal ‘cut-offs’ and that older patients and their families must be supported to challenge this where they suspect it is happening.
corner shield
CATERHAMSURGICAL SUPPLIES LTD Unit 16, IO Centre Croydon Road, Croydon CR0 4WQ Telephone: 020 8683 1103 Fax: 020 8683 1105 Email:
martin@caterhamsurgical.co.uk www.caterhamsurgical.co.uk
Distributors for:
LATEX FREE
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72