The concept of ‘complexity’ is synonymous with healthcare systems and is becoming increasingly prevalent in perioperative care. Advancing surgical technologies and approaches are driving the complexity of operations.
On record waiting lists, there is a growing mix of co-morbidity, polypharmacy, and multisystem issues such as frailty. We must however, avoid a reciprocal increase in the complexity of perioperative pathways as an attempt to manage these challenges. Introducing individual clinics for each long-term condition, with each one arranging a raft of blood tests and investigations, can be overwhelming for patients and healthcare professionals. Messages can get lost in the milieu of appointments, and important work can be duplicated or missed entirely leading to disengagement with the pathway. In order to manage complexity, perioperative care pathways must simplify the message of optimisation, empower patients, and support its workforce to deliver holistic, evidence-based multidisciplinary care.