94 What are the Components of Care Offered By POPS (Perioperative Medicine for Older People Undergoing Surgery) Services Across the UK; A Targeted National Survey

Abstract

Abstract Introduction Over the past five years the number of Perioperative medicine for Older People undergoing Surgery (POPS) services in the UK has increased.1,2 This expansion has occurred in response to the needs of an older, multimorbid surgical population with drivers for change coming from national reports and audit results. Different models of care have emerged; this study aimed to describe in detail the surgical specialties, components of care and staffing as delivered by current UK POPS services.3,4 Methods An electronic ten-question survey was sent to 31 acute NHS trusts, purposively selected from the British Geriatrics Society POPS network and previous survey respondents. Results Responses were received from 23 of 31 trusts (71%) with key results in Table 1. Eighty-three percent of respondents provided a geriatric-consult service, 13% a shared-care model and 4% had ceased their service due to inadequate funding. The surgical specialties covered included; general surgery (18/23), vascular (12/23) and other including urology, trauma, gynaecology (9/23). Team structures varied with 26% of geriatricians working independently and only 23% having dedicated allied health support. Forty-one percent of services were surgically funded, 36% medically funded and 23% from both directorates. Conclusions The predominant model of care remains a geriatric-consult service. The evidenced-based ‘shared-care’ model previously only in operation at a large teaching hospital has now been replicated in two smaller hospitals. A previously described model involving patients transitioning from surgical to geriatric medicine teams was not seen in practice in this study.4 In line with the NHS’ vision of rationalising and scaling innovation, this survey highlights the growing need to establish a standardised POPS model across the UK.