Pre-Operative Assessment Service

The first stage assesses whether you are “Fit to proceed” with surgery. To do this we will:

• Ask you questions about your health
• Check your height, weight, and blood pressure (or use recent measurements from elsewhere)
• Gather information about your medical care from other services
• Do a range of tests (such as a heart tracing, blood tests, breathing tests)

This may occur by phone, or face to face.

Then: For most people, we will be able to inform the surgical team that you are fit to proceed.

For some, as long as your surgery isn’t urgent, we will give you advice on improving your health. This may involve:

• Offering advice on your diet and lifestyle
• Asking you to stop smoking or reduce your alcohol intake
• Investigate you for other medical conditions we think you may have
• Asking your GP or a specialist doctor to improve your other medical conditions (such as diabetes or anaemia)

In some cases, we will identify that you are at higher risk of having problems after surgery.

• It is important that you know what these risks involve, so we would arrange for an appointment with an anaesthetist to discuss this with you in detail.
• We may need to make special arrangements for your care such as arranging an intensive care bed for you after surgery.

Then: Once we have said you’re okay to proceed with surgery, you’ll then wait for your date for surgery. In some cases, your surgeon will have given you a date, but this will only be confirmed once we’ve passed you fit.

We will also give you advice on fasting, and what medications you should stop before your operation.

The second stage is a Preparation Clinic is to make sure you are appropriately prepared for surgery. This will:

• Take place once you have a date for your operation.
• Will be a face to face appointment 2-3 days before your operation
• Prepare you by taking blood tests and performing swabs to screen for infection (including COVID-19).

Once these are done, we will ask you to stay at home and not have contact with anyone outside your household before surgery.

The result of your COVID-19 test will be received by your surgical team, and the ward where you will be admitted.

• If the result is negative you will not be contacted – you should follow your instructions for admission on the day
• If the result is positive your surgical team will get in touch and advise you to self-isolate according to national guidance. Your surgery will be delayed until you have fully recovered. In rare circumstances, your surgeon may discuss proceeding with surgery earlier, and go through the risks with you.
• On rare occasions the test may not produce a conclusive result, and you may be asked to re-attend for a second COVID-19 swab. This may result in a delay to your surgery.