Department of Health

Website of the Department of Health

Please note that this website has a UK government access keys system.

Standard One - Rooting out age discrimination

  • Last modified date:
    15 February 2008

The aim of this standard is to ensure that older people are never unfairly discriminated against in accessing NHS or social care services as a result of their age.

Standard

NHS services will be provided, regardless of age, on the basis of clinical need alone. Social care services will not use age in their eligibility criteria or policies, to restrict access to available services.

Progress

During the first two years we have driven changes in attitudes in both health and social services. It is now accepted that we should not discriminate against any individual simply on the basis of age.

NHS organisations have checked their written polices to ensure they have no age bias. Only a very small number have been found that discriminate against older people. In these cases, procedures are being reviewed.

At the same time, Councils and Care Trusts have received guidance to make sure everyone has fair access to services - regardless of age. And people's eligibility for care packages is now based exclusively on their needs and risk factors.

We are now concentrating on action to root out unwritten, implicit age discrimination.

We have also identified some national policies that appear to recommend treatment - or non-treatment - on the basis of age. These are generally thought to be based on good clinical evidence, but they need to be continually questioned.

One reflection of this new attitude can be seen in the greater action by hospitals in providing surgery for older patients. Between 2000 and 2002, for example, breast cancer surgery for patients 85 and over rose by 13%. Coronary artery bypass grafts increased by 16% for those 65 or over, the increase was 32% among patients 75 or over and 65% in the 85 plus age group.

Benchmarking tools

These tools are designed to help those responsible for commissioning or delivering services at a local level to compare patterns of treatment at different ages with those in other areas.

The tools focus on separate aspects of care and treatment covering

  • a number of acute hospital procedures (currently being updates to include PCT level data)
  • social care
  • blank tool allowing for the input of local information and comparisons within strategic health authority areas
  • primary care (in development)

The format and look of each tool is similar, though each backed with individualised data. An explanation of how to use each tool and how you might interpret results is given in individual user guides. These include some worked-through examples to illustrate the kinds of information and questions that can be raised by an analysis of the data.

It is important that you read the user guide and appreciate how the benchmarking tool can assist your considerations of age discrimination. It is crucial to its effective use that you recognise and are aware of what it will do, what its data analysis may tell you, and perhaps most importantly what it does not directly tell you about your services. Remember:

The objective of the benchmarking is to raise questions for further investigation rather than provide definitive answers.

Interpretation of results will require careful consideration.

A simple comparison of ratios between areas will not in itself tell you that age discrimination is or is not occurring in your services.

It does not set national benchmarks for the ratios of procedure rates to be achieved.

The King's Fund published a document which provides wider advice on the identification of age discrimination in health and social care, what it may look like and how it might be addressed. This places the use of the benchmarking tool within the context of it being one of a number of methods by which services and their delivery can be investigated for age discriminatory practices or effects. It was based largely on the experience and knowledge of individuals and organisations involved in the delivery of Standard One of the National Service Framework for Older People and was published in February 2003.

Download age discrimination documentation

The tools are provided as computer-based models available as a Microsoft Excel file (see below).

Note the age discrimination benchmarking tools below should be saved to a local drive before use. The tools will only function properly if loaded from their saved location. The documents contain macros.

Consultation and feedback of your views

We would welcome feedback on the use of the benchmarking tools, ideas about how they can be improved, made more user friendly or additional areas/information that you may wish them to cover.

Feedback can be sent by post to:

NSF OP Implementation Team
Department of Health
Room 722
Wellington House
133 -155 Waterloo Road
London
SE1 8UG

by fax to 020 7972 4863, or by using the email link below.

Access keys