Purpose Effective communication between surgeons and anaesthetists is crucial for safe patient care. This audit assesses the quality of surgical emergency inpatient referrals at a tertiary hospital, identifying areas of improvement. Methodology Data was collected via survey forms at the Anaesthetists in Charge (AIC) desk (June 21–Oct 31, 2024). Six communication aspects were identified from the literature, college guidelines, and surgeon-anaesthetist discussions: 1.Purpose of referral 2.Understanding of procedure 3.Relevant medical details 4.Logistic factors 5.Perioperative medications 6.Overall presentation Referrals were scored using a Likert Scale (0 = not covered, 3 = excellent). The data included the referral date, AIC’s comments, speciality, and referring doctor’s seniority. Results 57 referrals were recorded, with General Surgery contributing most (35.1%). HMOs provided 43.9% of referrals. The median score, IQR and range were 13, 8 and 17 respectively, indicating substantial variation in surgical referral quality. Using Braun and Clarke’s thematic analysis and interpretation-focused coding, three themes and seven subthemes emerged: 1.Information: Quality, comprehensiveness 2.Presentation: Clarity, length, tone 3.Suitability: Referral content, referring doctor The suitability theme highlights the need for senior surgeons to support juniors making complex referrals. Information emerged as the most recurrent theme, suggesting that accurate information was the most important part of a surgical referral. Conclusion Variability in referral quality is notable, with accurate information being most important. Supporting surgical team members could enhance their communication with anaesthetists, promoting safer care.