Hospitals are failing elderly patients, with many suffering unnecessary pain, a report has found.
More than one in five also experience “significant delays” between admission and their operation, which reduces their chances of recovering.
The study, from the National Confidential Enquiry into Patient Outcome and Death (Ncepod), examined more than 700 patients over the age of 80 who died in hospital within 30 days of undergoing surgery.
Just over one in three (38%) had received good care, 44% received care that could have been improved and 6% received care that was less than satisfactory.
Poor nutrition and serious illness linked to it were “very common” among the group, the study said.
A quarter of hospitals had no acute pain service, meaning people suffered unnecessarily.
In 68% of cases, patients were not reviewed by elderly care specialists, despite recommendations a decade ago that this should happen.
Report author and Ncepod clinical coordinator in surgery Ian Martin said: “Most patients were admitted as emergencies by very junior doctors without timely input of senior care of the elderly clinicians.
“There is still a long way to go to ensure good practice and appropriate care - this is despite our advice in 1999 and recommendations in the 2001 national service framework calling for specialists to be involved at every stage of elderly care.”
Ncepod clinical coordinator in anaesthesia, Dr Kathy Wilkinson, who also worked on the study, said pain was not monitored, addressed or controlled.
The authors of the report said it should be treated as high a priority as heart rate and blood pressure.
“It is shocking that the survey has revealed organisational failures to respond to the suffering of elderly patients,” Dr Wilkinson said.
“I hope our report is a wake-up call.”
The study, An Age Old Problem, said patients being admitted to A&E with diarrhoea and vomiting, or signs of infection, need to be assessed by a doctor with the right kind of expertise.
Care services minister Paul Burstow said: “This study paints a disturbing and unacceptable picture of the quality of care experienced by older people.
“It is part of the legacy of a system driven by targets and tick boxes.
“This report is a snapshot of the state of the NHS two years ago.
“Clearly, more must be done to improve the quality of care. That is why the coalition government is determined to make the NHS more patient-centred.”