This piece is a continued deep dive into the subject, of ‘fitness, function, or frailty’ and, perhaps, “fixing”. It’s essential listening for anyone interested in the latest thinking on this crucial topic and was a highlight of the London conference.

How can we integrate frailty and cognitive scores in risk assessment tools to facilitate inclusion in shared decision making? How can we improve a surgical colleague’s ability to identify frailty? Most patients will have an operation sometime in their life; should surgical school be renamed and moved to being a “well being” clinic and offered to all patients? What screening tools would you recommend if only minimal time or money is available? Is pre-op screening actually ‘public health’ and should it really be being done for everyone? What are the differences and where is the overlap between fitness functional capacity, frailty, and sarcopenia? In mild cognitive impairment, should we tell patient that it will work and postop and not be expected to fully recover? What strategies have you found most helpful in engaging surgeons with identifying their frail patients? How are we tackling the workforce shortage among geriatricians? What has your experience been in advising achieving physical fitness in patients who present to surgery with persistent pain which is a limitation?

This is part two of a two part piece. Each of the contributors comments upon talks which they gave at EBPOM 2020, all of which are now available as part of the TopMedTalk podcast. To ensure you are among the first to hear information of this kind please investigate www.ebpom.org for more details about how you can attend our online conferences.

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Presented by Scarlett McNally, Deputy Director of The Centre for Perioperative Care (CPOC) consultant Orthopaedic Surgeon, Eastbourne DGH, UK and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London with questions from the online audience for their guests; Denny Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton, Daniel Conway, Consultant in Anaesthesia and Critical Care, Group Lead for Perioperative Medicine, Manchester Royal Infirmary, UK and Chair of the Manchester Perioperative Medicine Society, Jude Partridge, consultant geriatrician POPS, honorary senior lecturer, King’s College London, Chairs the British Geriatrics Society POPS SIG, Vicki Morton, Director of Clinical and Quality Outcomes at Providence Anesthesiology Associates, P.A.