Intended for healthcare professionals


Poor inpatient care for older people

BMJ 2011; 342 doi: (Published 03 February 2011) Cite this as: BMJ 2011;342:d373
  1. Stuart G Parker, professor1,
  2. Simon Conroy, senior lecturer2
  1. 1Sheffield Institute for Studies on Ageing, University of Sheffield, Barnsley Hospital NHS Foundation Trust, Barnsley, S75 2EP, UK
  2. 2Ageing and Stroke Medicine Group, Department of Cardiovascular Sciences, University of Leicester, Leicester Royal Infirmary, Leicester, UK
  1. s.g.parker{at}

Good care for frail older people should be part of mainstream clinical practice

In 1963, in a message to Congress, John F Kennedy said that a society’s quality and durability can best be measured by the respect and care given to its elderly citizens.1 By this measure, the recent report from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) on the perioperative care of older people gives our society cause for concern.2 The report has been widely received as demonstrating inadequate care for older people undergoing surgery, and its findings described as shocking, disturbing, and unacceptable.3


The report describes an observational study of more than 800 patients over the age of 80 years who died within 30 days of a variety of surgical procedures. There was nothing extraordinary about these patients—they were typical in many ways of the population accessing acute care in the modern NHS. They were older; nearly all had comorbidity (94%); disabilities were common, as was delirium or dementia, or both; and many (66%) were identifiably frail. A key finding was that only …

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