Purpose Older surgical patients often have unrecognised frailty and multimorbidity. In 2023, Blacktown Hospital embedded a perioperative physician (geriatrician) within the surgical ward as part of the Perioperative Care for Older People undergoing Surgery (POPS) model. The perioperative physician saw individual at-risk patients on the ward as well as leading a daily MDT with a focus to optimising surgery readiness and recovery in the perioperative period. The aim was to shift from reactive consultation to proactive, team-based care. Methodology A three-month retrospective review examined all geriatric referrals on the surgical ward. Data included referral source, reason for referral, and timing within admission. This was followed by a staff survey (n=32) exploring perceptions of workflow, communication, and care quality. Results Of all referrals, 20% originated from the surgical team, while 80 % were triggered through other means, primarily real-time identification by the ward-based geriatrician, followed by family, other staff and patient-requested. Referrals occurred earlier in admission and addressed broader issues such as frailty, cognition, delirium prevention and discharge planning. Staff survey: 84% reported improved understanding of the patient journey, and 71% felt that their engagement with MDT improved. Qualitative feedback described earlier problem-solving, calmer workflow, and stronger collaboration. Conclusion The majority of referrals occurred because a geriatrician was physically present, engaging with patient and team to identify unmet needs in real time. Ward-embedded geriatrics on surgical ward shifted the culture from reactive consults to shared, proactive care - enhancing communication, teamwork, and shared decision making. Improved understanding of the patient journey created deeper engagement with the unique circumstance and goals of patients and their families. This low-cost, scalable model strengthens system performance for older surgical patients.