Where are we now in perioperative medicine? Results from a repeated UK survey of geriatric medicine delivered services for older people

Geriatric medicine services for older surgical patients in acute hospitals: Results from a binational survey

“…Similar to the UK survey, funding was the most commonly perceived barrier. Most existing proactive surgical‐geriatric medicine services are funded by the geriatric medicine budget, both here and in the UK . The UK survey found an increase in the number of services funded by surgical directorates .…”

“…Most of these services were in an inpatient setting, and apart from minimum age criterion, few other inclusion criteria such as frailty were used despite the established association between frailty and adverse surgical outcomes . The UK has seen an increase in perioperative geriatric medicine services, albeit these have been reactive consultation services, which already exist in 96% of acute hospitals in Australia and New Zealand in this study.…”

“…Most existing proactive surgical‐geriatric medicine services are funded by the geriatric medicine budget, both here and in the UK . The UK survey found an increase in the number of services funded by surgical directorates . A key to obtaining funding for new services is to gather evidence of clinical and economic effectiveness.…”

“…Two surveys in the UK showed an increase in the number of trusts providing geriatric medicine services for older surgical patients from 38 (29.2%) in 2013 to 81 (53.3%) in 2018 with a large increase in reactive consult services. The UK NELA report found that 19% of patients aged 70 years or older undergoing emergency laparotomy had input from a geriatrician in 2016, and 3% of hospitals had geriatricians providing regular proactive assessment of patients after surgery .…”

Perioperative medicine for older people: Learning across continents

“…There is a clear enthusiasm for specialist perioperative services for older patients shown in this survey yet the majority of Australasian services remain reactive in nature. This picture is likely to change, as seen in the UK, where between 2014 and 2019, an expansion in proactive services was observed . Reported barriers to establishing services are also similar across nations with a lack of funding and trained workforce most commonly cited …”