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Implementation of Comprehensive Geriatric Assessment based perioperative medicine services to improve clinical outcomes for older patients undergoing elective and emergency surgery with cost effectiveness

Older people have more operations than younger people and also have more complications after surgery, such as chest infections, kidney problems, slow recovery and longer hospital stay. This is because older people often have other problems like heart disease or poor memory. These problems need treatment from experts called geriatricians. Having geriatricians care for older people who need operations is not standard in the NHS right now. A service called Perioperative medicine for Older People undergoing Surgery (POPS) was set up at one NHS hospital by geriatricians to help older people get better outcomes after operations. POPS was set up together with patients, carers, surgeons, anaesthetists, nurses, therapists and managers. It uses a method of care called Comprehensive Geriatric Assessment. Studies show that using Comprehensive Geriatric Assessment as part of POPS services can reduce complications after surgery, help people leave hospital sooner and save the NHS money. Some NHS hospitals have now set up POPS services, but not all, meaning not all NHS patients get the same quality of care. We know that setting up POPS services can be hard but our work has shown this can be done. Our research will test how POPS services can be set up in more NHS hospitals to improve care for older patients having operations and save money for the NHS.

poster titled 'Improving care for older people having surgery'. Poster details the reasons behind the statement, the details of the surgery process and the work done by the team to improve the care for older people.


Can CGA-based perioperative medicine services (POPS services) be implemented throughout the NHS, to improve clinical outcomes for older patients undergoing elective and emergency surgery with cost effectiveness?


We will use our ‘strategy’ to see if we can set up new POPS services in 18 hospitals. We will measure whether we can do this quickly, how well POPS services run, whether POPS services help people to get better more quickly after an operation and whether this saves the NHS money. We will collect information about how long people stay in hospital after an operation, describe complications after surgery and measure patient’s quality of life. We will also talk to patients and staff about their experiences of new POPS services. Our research will use a mix of information from staff, from hospital records and directly from patients and carers. We will look at these data using statistics and by describing common themes. This will tell us if POPS services can be set up across the NHS, whether patients benefit and if money can be saved.

Summary of Findings

The research team have made lots of contacts with patient, public and staff groups such as charities, policy makers and healthcare professional groups. Using these contacts, we will share our findings with patients, the public, NHS staff and policy makers through talks, articles, press releases, social media, videos, websites and meetings to change NHS policy, save money and improve care for patients.

Project status: Starting

Principal Investigator


Funding Body: National Institute for Health Research (NIHR)

Amount: £1,540,771.70

Period: March 2024 - May 2027