Elderly cancer victims ‘failed by NHS ageism’ with patients written off as too frail for treatment
Elderly cancer sufferers die in greater numbers than younger patients because of NHS ageism, official figures suggest. Only half of sufferers aged 75 and over will live more than a year, compared with the three quarters of those in middle age who can expect to do so.
Campaigners warn that thousands of patients are written off by doctors who assume they will prove too frail for lifesaving treatment.
Figures from the Office for National Statistics show that in 2009 only 53 per cent of patients over 75 diagnosed with cancer were alive one year later. By comparison 74 per cent of those diagnosed aged 55 to 64 survived for this length of time. Many are likely to live far longer.
Macmillan Cancer Support estimates that up to 15,000 patients over 75 are dying prematurely every year – based on comparisons with survival rates in other European countries. Mike Hobday, director of policy and research at the charity, said: ‘We know older people are less likely to receive curative treatment than younger patients.
‘We are concerned that treatment decisions are too often being made on the basis of a patient’s age, regardless of how fit or frail they may be. Overall cancer survival is improving but worryingly older people are still much less likely to survive the first year.’
Sarah Woolnough, Cancer Research UK’s director of policy, said: ‘Older people may feel reluctant to see a doctor or they may dismiss possible cancer symptoms as part of old age. If cancer survival rates in the UK are to improve we urgently need to address variations in survival by age.
‘Spotting cancer early really is key, cancer patients of all ages need to be diagnosed as soon as possible so that they can be offered all the treatment options available, regardless of how old they are.’
Emergency department target may not have improved patient care
Research from the University of Sheffield has discovered that a Government target for NHS Emergency Department (ED) length of stay, which has now been scrapped, may not have improved patient care.
An extensive study led by Professor Suzanne Mason of the University of Sheffield found that the Government´s controversial rule that no emergency patient should wait more than four hours from arrival to admission, transfer or discharge, has improved waiting times but may not be the best way to manage ED crowding or deliver high quality patient care.
The research entitled England´s Four Hour Rule – A Case of Hitting the Target but Missing the Point, examined waiting times from 2003 to 2006 when the target was fully introduced. The research showed that total length of patient stay actually increased and activity in the last 20 minutes of the four-hour window grew every year since the rule was introduced.
Professor Mason said: “The law of unintended consequences seems to be at work, even though the rule came out of a strong intention to improve patient care. We hoped that the target would have led to improved processes leading to shorter wait times in the ED without diminishing time for physician-patient interactions. But we did not observe this pattern.”
“Our results suggest that an absolute cut-off may not be the best way to manage ED crowding. However there was a marked improvement in the proportion of patients being seen and leaving within four hours in the EDs we looked at.”
Researchers analysed 735,588 visits in 15 EDs over a four year period. The proportion of patients leaving the ED within four hours increased from 83.9 per cent in 2003 to 96.3 per cent in 2006.
“Patients destined for hospital admission are the most challenging to manage within a stringent time frame,” said Professor Mason.
“The four hour rule seems to have shown less benefit for the elderly than for younger patients. The elderly are more vulnerable and would be likely to benefit more from early transfer to a hospital bed.”
Although the total average time in the ED fell initially from 119 minutes in 2003 to 107 minutes in 2004, by 2006 that number had risen again to 114 minutes. The percentage of patients leaving the ED in the last 20 minutes of the four hour window increased from 4.7 per cent to 8.4 per cent.
Compared to 2003, the elderly spent around 40 minutes less in the ED in 2004 and 2005, and 47 minutes less in 2006. However, the proportion of elderly patients who exceeded the four-hour window was 7.6 per cent which is much greater than the proportion of younger patients which was recorded at 2.9 per cent.
Set by the Department of Health in 2005, the target stated that 98 per cent of all ED patients must be seen, treated and leave the department (for home or an inpatient bed) within four hours. The target was set in response to lengthy waiting times, crowded waiting rooms and consequent compromised standards of care. However, after nearly six years in place, the Government abolished the target in April 2011 and it was replaced by quality measures.
Notes for Editors: This research was carried out by Professor Suzanne Mason, Joanne Coster and Dr Jennifer Freeman from the University of Sheffield´s School of Health and Related Research with Ellen Weber at the University of California, San Francisco and Dr Thomas Locker at the A&E Department at Barnsley Hospital Foundation NHS Trust.
Sir David – another presenter we cannot totally trust
No ONE wants to criticise Sir David Attenborough, given the amazing television he has made and the work he’s done to preserve wildlife and educate us about the way we are destroying the planet.
But in the case of Polar Beargate, he would be better to recognise that what he and the BBC did was duplicitous and simply apologise.
The dodgy footage was the most touching scene in Episode Five of Frozen Planet – watched by some eight million trusting viewers.
The pictures would have been NO LESS remarkable if Sir David had simply mentioned that they were effectively library footage, shot in what we now know was a Dutch animal park.
After all, as he pointed out on This Morning: “If you put a camera in the wild in a polar bear den, she would either have killed the cub or she would have killed the cameraman.” He could have easily explained this at the time. It is disingenuous to claim that this would have spoiled the atmosphere and to argue that the BBC “did not keep it secret”.
Attenborough’s voiceover for the footage sighed in wonder: “On these slopes beneath the snow, new lives are beginning.
“The cubs are born blind and tiny. In two more months polar bear families will emerge on the snowy slopes all around the Arctic… but for now they lie protected within their icy cocoons.”
This is clearly misleading. And viewers will be disappointed to find out that Sir David is yet another TV presenter they cannot totally trust.
References are now ‘not worth the paper they are written on’ because of Britain’s data protection laws
Job references are ‘not worth the paper they are written on’ because of controversial data protection laws, a peer said yesterday. Baroness Deech said the rules meant those writing references for university and job applicants are too scared to be honest because candidates can find out what was said about them.
The Data Protection Act gives people the right to ask to see all the written information that is held about them, including a reference from a school, university or former employer.
Lady Deech, who gained extensive experience of looking at references during her time as a law tutor at Oxford University, said: ‘Before the Data Protection Act, we got references from schools.
‘They might say: “Young So and So may be very shy and quiet, but we assure you she is very bright, give her a chance. ‘Her mother is an alcoholic. Her father left her. But we know she will deliver.’
‘It actually helped you give under-privileged people a chance. Or from a public school, they would write: “Young Camilla will give a polished performance, but we have had to work very hard with her.”’
But Lady Deech said in an interview that the Act, which came into force in 1984 but was revised in 1998, has put an end to such honesty. Lady Deech, a crossbencher who sits on the Lords Communications Committee, added: ‘They won’t say that now. All references just say: “Young So and So will get three As. She has been a good student.”
‘[This is] because they know the parents can see it. They are not worth the paper they are written on, and I think that’s really wrong. It has destroyed the ability to choose.’
Lady Deech said that if she were made Prime Minister for a morning, she would put abolishing the Act at the top of her ‘to do’ list.
But a spokesman for the Information Commissioner’s Office, which promotes data privacy for individuals, dismissed Lady Deech’s comment as ‘a misconception’.
He said: ‘The Act gives individuals the right to access information that is held about them. ‘This can help people in many areas of their lives – from ensuring information is accurate on their credit file to seeing their medical records, or seeing what a prospective employer has been told about them if they are refused a job.
‘To suggest that this right prevents employers providing honest references is a misconception. ‘All it means is that employers who write references should be able to justify their comments.
‘If there are specific problems with an employee it would be reasonable to expect that the employee would already have been made aware of these.’
Dr Jill Miller, an adviser to the Chartered Institute of Personnel and Development, urged those giving references to be totally truthful, as long as they can substantiate their comments. She said: ‘What is important when writing a reference is that all data given should be based on fact or capable of independent verification. ‘As a guide, references should be fair, accurate and not give a misleading overall impression of the employee.’
It comes at a time when the hunt for a job is a nightmare for young people, who are competing for work as unemployment hits a 17-year high. More than one in five people between the age of 16 and 24 is unemployed, smashing the one million landmark for the first time, according to the Office for National Statistics.
Tanya de Grunwald, founder of the careers website Graduate Fog.co.uk, said: ‘Youth unemployment is no longer a problem – it is now a full-blown crisis.’
Even before the crisis, there was evidence of job candidates lying on their CVs in a desperate bid to get a job. One winner of the BBC show The Apprentice, Lee McQueen, came under fire for pretending to go to university for two years. In fact, he had attended Thames Valley University for four months.
One of the most famous CV cheats was Alison Ryan who was hired to a £125,000 prestigious job as director of communications at Manchester United. She boasted that it was ‘a dream come true’ but a Daily Mail investigation revealed that she had lied about her past. Fans quickly nicknamed her ‘Alison Wonderland.’
Leadership shortage as British schools struggle to recruit new head teachers
Schools are facing a leadership crisis as primaries and secondaries across England fail to recruit head teachers, according to a new report.
More than a third of primary schools and almost a fifth of secondaries struggled to find a head after advertising the position last year.
Roman Catholic schools are being left with the most acute shortages because they traditionally restrict recruitment to religious applicants.
Head teachers’ leaders blamed rising workloads, the target culture in schools and a real-terms cut in pay, saying that teachers were reluctant to take on the extra pressure of headship – despite the publication of official data earlier this year that showed 700 heads or deputies earned more than £100,000.
Russell Hobby, the general secretary of the National Association of Head Teachers, said the report showed “worrying trends in the school labour market at the very top level”.
“Headship is a wonderful job, with challenges and satisfaction in equal measure,” he said. “We want people to become heads and experience the unparalleled power to make a difference to young lives. Against this are the prospect of a 20 per cent real-terms pay cut over the next four years despite rising targets, longer hours, increasing threats of violence and lower job security.’’ Mr Hobby added: “We run the risk of running out of heads, with dramatic damage to the trend of school improvement.”
A report by Education Data Surveys analysed the recruitment of senior school staff in the 2010-11 academic year.
It found that about 36 per cent of primary head teacher positions had to be advertised more than once after failing to find a successful applicant the first time, compared with 34 per cent a year earlier. At the same time, some 19 per cent of secondary school jobs were advertised more than once – the same as 12 months earlier.
According to figures, the number of vacancies for deputy heads dropped, suggesting that existing deputies are remaining in the job for longer – and failing to aspire to top positions.
The report – which was commissioned by the NAHT – described the development as “very concerning”. “As existing deputies come closer to retiring, there is a real danger that schools will face even greater difficulty in recruiting head teachers in years to come if there is not an available and ample supply of deputy head teachers from which to draw candidates,” it said.
Earlier this year a government consultation document outlined plans to hand Britain’s brightest students £20,000 to train as teachers in an effort to improve standards. Under the reforms, graduates with first-class degrees would be eligible for the most generous bursaries to teach shortage subjects such as science and maths.
The plans were designed to raise the profile of the teaching profession amid fears that English state schools were falling behind those in other developed nations.
Ministers also signalled their intention to train more students in schools – instead of universities – in a move seen as an attack on the Left-wing teaching establishment.
Under the strategy, student teachers will be expected to display better standards of English and maths before being allowed to qualify – scrapping a rule that gives trainees unlimited attempts to pass basic tests in the three-Rs.
The Government will also attempt to encourage former Armed Forces personnel into the classroom with the establishment of a new “Troops to Teachers” programme.