This report produced by The Royal College of Surgeons of England and Department of Health describes the key issues and standards related to the higher risk general surgery of the frail older patient.

Among these patients, emergency surgery and unscheduled management of complications is common and this group of patients are one of the largest consumers of critical care resources. The health and financial costs are considerable.

Evidence indicates that the peri-operative pathway followed by patients requiring emergency surgical management is frequently disjointed, protracted and not always patient centred. Outcomes are known to vary substantially and could be considerably improved.

The report makes recommendations which the authors say should be deliverable within two years in all acute hospitals undertaking unscheduled general surgery in adults and that doing so would make an appreciable difference to outcomes.