Seen the doctor on the Tele? Patient centred care needs to arrive for all, and none more urgent than for our older patients

Chris Subbe is a Consultant in Acute, Respiratory & Critical Care Medicine. He is a Service Improvement Fellow with the Health Foundation. He does research on patient safety at Bangor University. He tweets @csubbe

Unsurprisingly many of us have more medical needs as we get older. While some people manage to stay remarkably fit, for others it is getting more difficult to get around town or worse across country. The hike around an overflowing car park of an inner-city hospital does surprisingly little for mobility, and most people get little value from sitting in an outpatient waiting area to wait while their medical team is struggling with the application of queuing theory to healthcare.

A few years ago, when granddad was sent a follow-up appointment for his cardiac surgery several months after the operation, I was suspicious. I rang the secretary of the colleague who had done an amazing job on his heart to ask for the reason for the review. “An important part of quality assurance: we like to make sure that everything has gone well”. I explained that granddad had been in hospital, survived prolonged rehabilitation, and had already been followed up by an excellent local geriatrician and one of our brilliant cardiologists. He felt well. I suggested cancelling the appointment.

Top of the POPS: the future of perioperative care

Jason Cross is an Advanced Nurse Practitioner for the Proactive Care of Older People Undergoing Surgery (POPS) team at Guy’s and St Thomas’ Hospital and is a member of the BGS POPS Special Interest Group. He Tweets at @jdcross1970

It’s been an exciting and challenging three years since I last wrote in the BGS blog, and while the messages haven’t changed much, the field of perioperative medicine continues to gather momentum.

In 2012 I wrote about the publication of An Age Old Problem (2011) and Access All Ages (2012) and how both these reports highlighted the deficiencies in surgical care for the older patient, and how geriatrician input was cited as an essential component to improving these issues.

These recommendations have been further supported by the recent publication of the new perioperative pathway vision document from the Royal College of Anaesthetists, titled Perioperative Medicine: The Pathway to Better Surgical Care. Here we note an emphasis on collaborative working with a focus on improving the outcomes and efficiency throughout the surgical pathway.