Reducing deaths after emergency surgery for older people is one of the most urgent challenges facing the NHS today.

In England and Wales, more than half of the 30,000 emergency abdominal operations carried out each year are on people over 65. This number is increasing as more people than ever live into old age. A disproportionate number of these people compared to the rest of the population will die in hospital.

Even more worryingly, evidence suggests that older people in England & Wales have a higher likelihood of dying after emergency surgery based on where they receive care – a situation dubbed a ‘Postcode lottery’. The UK as a whole also has worse rates of mortality after emergency surgery than comparable European countries and the USA.

Because of the variation in outcomes based on geographical location, it’s evident that care pathways in some NHS Trusts are distinctly better than others.

Clearly, patients should be entitled to the best possible care no matter their age or where they live. Our new research is helping to ensure this can be delivered.

Bowel Research UK funded researchers will run a national audit to save lives by establishing best practice.

The research team will carry out:

– Retrospective and prospective analysis of data to see how treatments & interventions are used, and how effective they are within the NHS

– Health economics assessment of a range of identified interventions

– Assessment of the impact of medical intervnentions throughout the care pathway, looking at how effective and useful they are from a patient, carer and health professional standpoint

As a result we will be able to address the lack of knowledge around the best options for care before, during and after emergency surgery for older people. This has so far hampered efforts to improve the situation, because different practices are followed in different hospitals.

Our study wants to identify why some Trusts achieve better outcomes than others, and how their success can be replicated throughout the NHS. The team will do it through analysis of data collected throughout a patient’s journey – from admission to discharge and in the months after through follow-up appointments.

We also know that many proven techniques to enhance surgical care are not often applied in emergencies, often due to time constraints. We want to work out how these constraints can be addressed, and how optimum care can be built into the emergency setting.

Once complete, we will be able to begin to recommend optimum pathways for all hospitals to follow – significantly reducing mortality rates, as well as postoperative complications that ruin lives.