Perioperative medicine for older patients: how do we deliver quality care?

The demand for surgical intervention in older people is rising due to the growing older population with multimorbidity. Yet older people continue to have reduced access to surgery and have more adverse postoperative outcomes than younger people. Current models of preoperative risk assessment and optimisation are poorly suited to this complex surgical population. Furthermore, there has been little emphasis on perioperative management of older people in national anaesthetic and surgical curriculums. New models of care and training in perioperative medicine for older people are evolving, with national reports calling for collaboration between geriatricians, general physicians, anaesthetists and surgeons. Such collaboration is necessary to impact clinical service development, research agendas and education and training. In this article, we discuss the challenges and potential solutions in the establishment of quality surgical care for older people.