Age discrimination: NHS is failing the over-50s, claims university study
People aged 50 and over, but especially the old and frail, are not receiving basic standards of healthcare, according to new research.
Experts found shortfalls in the quality of care offered by the NHS and private providers to patients with conditions such as osteoarthritis, incontinence and osteoporosis.
But they found that doctors paid particular attention to conditions where assessments earned them extra money, including heart disease, diabetes and high blood pressure.
Dr Nick Steel, the senior lecturer in primary care at the University of East Anglia, who led the study, said: "One of the conditions that came out worst was osteoarthritis, where we asked people if they'd received basic advice such as doing exercises to control the condition, and whether they had effective pain relief.
"At the more severe end of the scale, for those with severe osteoarthritis, we asked if they had been given the opportunity to see a specialist to talk about joint replacement.
"There were also issues around whether elderly patients had been asked the reason for their falls. These types of areas did not fare so well in the study."
The research, published in the British Medical Journal, found the quality of healthcare for people with common health conditions "varied substantially by condition".
Scores on the quality of care ranged from 83% for heart disease to 29% for osteoarthritis.
Overall, only 62% of the care recommended for people aged 50 and over is actually received in England, the research found.
The study, which involved 8,688 people, examined 13 different health conditions including heart disease, diabetes, stroke, depression and osteoarthritis.
A series of questionnaires and face-to-face interviews were used and the findings assessed against a series of markers on the quality of care, approved by a medical panel.
These included established guidelines on managing conditions, comparable to those issued by the National Institute for Health and Clinical Excellence (Nice).
The researchers found substantially more care was provided for general medical conditions (74%) than for geriatric conditions (57%), including falls, osteoarthritis, urinary incontinence, cataract problems, hearing problems and osteoporosis.
Conditions that come under the Quality and Outcomes Framework (QOF) - which give incentives to GPs - received better attention. In 75% of such cases, people got the right treatment.
Steel said it could not be concluded that care for people with conditions outside the QOF had got worse, but it was not improving in line with conditions included in GPs' contracts.
People were far more likely to receive screening and preventative care (80%) than treatment and follow-up care (64%) or diagnostic care (60%), the study found.
The authors concluded: "Shortfalls in receipt of basic recommended care by adults aged 50 or more with common health conditions in England were most noticeable in areas associated with disability and frailty, but few areas were exempt.
"Efforts to improve care have substantial scope to achieve better health outcomes and particularly need to include chronic conditions that affect quality of life of older people."
Gordon Lishman, the director general of Age Concern, said: "These figures show that age discrimination within the NHS is still rife.
"The rewards system for GPs to treat particular conditions has worked - but this hasn't included health problems older people particularly suffer from like depression, falls, and vision and hearing problems.
Kate Jopling, the head of public affairs at Help the Aged, said: "These depressing results show that, when it comes to healthcare, all too often older people and the conditions that affect them come far down the pecking order.
"This kind of ageist treatment is precisely why legislation against age discrimination is needed.
"The government has announced this will form part of the forthcoming equality bill but no timeframe or process has been agreed - until that happens, older people will continue to be short changed by the health service."
A spokeswoman for the Arthritis Research Campaign said: "We know that many older people with osteoarthritis are often fobbed off by GPs and told: 'It's your age you've got to live with it', rather than being offered practical advice on weight loss, exercise and pain relief, or a referral to see a physiotherapist.
"Standards of care vary enormously around the country and it's simply unacceptable."
The Department of Health said: "Older people have a right to high quality care, regardless of their age.
"It is unacceptable for them to be treated any differently. Our recent Darzi review sets out a framework for improving the quality of care for everybody that uses the NHS.
"A lot of progress has been made already with the treatment and care of older people but we recognise more can be done.
"We have recently started work on providing an increased focus on preventative care for older people. The prevention package will include an expert group to help the NHS better provide services for falls, fractures and osteoporosis."