The Peri-operative care of Older People undergoing Surgery (POPS) special interest group (SIG) was launched at the second POPS education and training day on the 2nd March 2012. The group’s objectives are to:
Improve knowledge of issues related to peri-operative care for older people undergoing both emergency and elective surgery
Provide a forum for education and training in peri-operative medicine for medical and allied health care professionals
Facilitate national dissemination of effective models of service delivery and work towards standardisation of clinical care for older surgical patients
Facilitate collaboration between all stakeholders involved in the care of older surgical patients (across elderly medicine, anaesthesia, surgery, allied health care professionals and the voluntary sector)
Promote collaborative research across units, disciplines and specialties aiming to improve outcomes for older surgical patients
A group of interim officers has been appointed to take the SIG forward until such time as a first Annual General Meeting is held when officers may be nominated and elected by the members of the SIG.
The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) has published another thorough and methodologically robust report, Lower Limb Amputation: Working Together. On this occasion they examined the care of the non-traumatic amputee across the UK and concluded that “only 229/519 (44.1%) of patients were receiving a standard of care with which the advisors would be happy for themselves or their family and friends. In other words, clinical management could have been better in half of the patients included in the study”.
Unsurprisingly, the majority of cases reviewed in this report were older, multimorbid and due to the lower limb amputation, at a transition point in terms of functional status. This older, multimorbid population were inadequately prepared for surgery (only two fifths of elective patients had preassessment) and commonly required medical input from a physician postoperatively (60%). So, did NCEPOD miss an opportunity to link past reports with this current review? Continue reading →
Following the publication of the National Confidential Enquiry into Patient outcome and Death (NCEPOD) report An age old Problem 2011 and the Royal College of Surgeons (RCS) report Access all ages 2012, interest in the specialist area of perioperative medicine for the older surgical patient is gathering momentum. As a result, clinicians, commissioners and patients are recognising there is a need to have geriatrician input in surgical pathways for older people. Continue reading →
Dr Jugdeep Dhesi is Chair of the BGS Peri-operative Care of Older People Ungergoing Surgery SIG (POPS) and is consultant physician and clinical lead for the POPS service at Guy’s and St Thomas’ Hospitals.
The number of frail older people undergoing elective surgical procedures is rapidly increasing. In fact the number of older people undergoing operations, as a proportion of all those having surgery, is increasing more rapidly than is the proportion of frail older people across the population as a whole.
There are a number of reasons for this. Advances in surgical technique and improvements in anaesthetic management have made it possible to operate safely on patients who would have been considered too frail for surgery in the past. At the same time patients and doctors now expect that they will be able to receive operations much later in life. Continue reading →