The National Surgical Quality Improvement Project (NSQIP) is a global initiative to audit and improve surgical services. NSQIP auditors found our unit has higher-than-expected unplanned readmission rates, and existing data suggests over 65s are more likely to be readmitted than younger populations. Our project aimed to identify risk factors and reasons for over 65s representing to hospital after surgery and to develop a quality improvement project to reduce representations and readmissions. This retrospective audit collected data on over 65s undergoing general surgical procedures in 2023 who had an unplanned representation to ED or readmission to hospital within 30 days of their index operation. There were 62 representations and 32 readmissions from a total of 1159 cases. 5.34% of general surgery cases in over 65s resulted in a representation within 30 days, and 2.76% of cases resulted in unplanned readmission within 30 days. NSQIP data for the first three months of 2024 showed the readmission rate for general surgery across all ages was 6.61%. Median time to representation was 10 days, and median readmission duration was 3 days. Surgical site infections (SSIs) represented 1 in 6 representations, with most requiring readmission, and severity ranging from mild cellulitis to necrotising fasciitis. The over 65s had a lower-than-expected rate of readmission compared with all ages. Simple wound issues and SSIs represented a large burden of both readmissions and representations, some of which could be preventable. Most representations happened before the first scheduled follow-up, indicating a need for improved access to the surgical team.