The public sector equality duty’s role in planning the commissioning of healthcare services for older patients: a justice perspective

The financial strain placed on healthcare systems, along with growing health needs and an increasingly ageing population, has led to calls for age-based healthcare rationing. A key question, therefore, concerns the extent to which justice is achieved for older patients in healthcare resource allocation. This work forms a three-dimensional adaptation of justice for healthcare resource allocation and older patients, consisting of redistribution, procedural justice, and recognition, to create a justice lens. This lens assesses the UK Public Sector Equality Duty's (PSED's) role in commissioning healthcare services and its objective to eliminate discrimination. This assessment determines the extent to which justice is achieved for older patients, addressing the lack of age discrimination case-law in healthcare resource allocation. This assessment finds that the PSED's legal framework does not satisfy the justice lens. A healthcare commissioning guide is subsequently developed, fulfilling the justice lens, suggesting steps promoting justice for older patients through equality in allocating healthcare resources.