Improving Surgical Care for Older Adults: My Experience at Guy’s and St Thomas’ Hospital

Older surgical patients often face higher risks and complications. Addressing these challenges requires a shift in how we approach their care. During my Short-Term Scientific Mission (STSM) at Guy’s and St Thomas’ NHS Foundation Trust in London, I had the chance to learn firsthand from the Perioperative Medicine for Older People undergoing Surgery (POPS) service — a pioneer program integrating geriatrics into surgical care pathways.

Throughout my two-month stay, I was fully involved in the POPS team’s activities, from outpatient preoperative assessments to inpatient ward rounds and multidisciplinary discussions. I rotated through various specialities, gaining a deeper understanding of how comprehensive geriatric assessment (CGA) can be adapted across different surgical fields to improve outcomes.

One of the most valuable aspects of my experience was participating in weekly case discussions, where complex patients — often with high perioperative risk — were reviewed by the POPS team (geriatricians, specialised nurses, and allied health professionals). These sessions highlighted the critical role of CGA in surgical decision-making, risk stratification, and personalized patient care planning.

Beyond the perioperative clinics, I also gained experience in the emergency geriatric unit and a post-acute surgical rehabilitation ward. These exposures showed me the importance of early geriatric interventions in preventing complications, promoting recovery, and ensuring smoother transitions of care.

Additionally, I received structured training on how to design and implement POPS-like services in hospitals where geriatrics is still developing. We discussed strategies for stakeholder engagement, building multidisciplinary teams, designing screening protocols, and using quality indicators to monitor progress.

Developing perioperative geriatric services comes with challenges, such as limited resources, lack of trained professionals, and resistance to change. However, through strong multidisciplinary collaboration, early identification of risks, and patient-centered care, it is possible to overcome these barriers.

This experience has given me a practical roadmap and renewed motivation to help bring geriatric expertise into surgical care in my home institution. I plan to share this knowledge through training sessions, advocacy work, and service development projects, helping to expand access to safer, more personalized surgical care for older adults.

I am grateful to the entire POPS team for their generosity and mentorship and excited for the opportunities ahead to contribute to the future of perioperative geriatrics.