More than two thirds of cancer diagnoses occur in people aged over 65 years. However, compared to countries with similar health care systems, the outcomes for older people in the UK following a cancer diagnosis are worse in relation to experiences of care and treatment, quality of life and survival.
Achieving World-Class Cancer Outcomes – A Strategy For England 2015-2020 set out a welcome ambition to improve cancer outcomes, with a review of the cancer workforce recommended as an important activity to achieve this goal. The workforce across health and social care remains a critical component to the story of improving outcomes for older people. Following recent evidence showing trainee oncologists’ confidence to treat older people is low, research has identified an over-reliance on age as a determining factor in decisions about treatment and a lack of skills and training specifically related to ageing within the healthcare workforce core curricula. In light of this, the Expert Reference Group for the Older Person with Cancer – established by Macmillan Cancer Support to bring together patients with health and care professionals to address poor outcomes in older people with cancer – commissioned a review of evidence, and found that the current workforce is not well prepared to meet the needs of older people living with cancer. As the population ages, the gap between what can be provided by the current workforce and what older people actually need is likely to grow. There is evidence that policy and practice is shifting to better reflect older people’s needs, but system-wide effort is required to close this gap.