Preparing for major surgery

Pre-operative assessment

If you are having an operation, you should have a pre-operative assessment to check your fitness for surgery unless you are having a minor procedure under local anaesthesia. This is usually a nurse-led clinic and takes place several weeks before your operation. You must attend your pre-assessment appointment – otherwise your surgery may be cancelled.

The pre-assessment appointment involves:

• taking a medical history
• checking your current medication – please bring a list of your prescribed medications
• recording height/weight and blood pressure measurements
• taking blood tests and an ECG (heart trace recording), if needed
• doing a urine test, if needed
• doing a skin swab to see if you are carrying a bacteria (MRSA)
• explaning how to prepare for your surgery, including dietary instructions for the day before surgery
• planning for what happens when you leave hospital after your procedure If you have significant medical problems, you may also be assessed by a consultant anaesthetist at a further appointment. Some older patients may also be referred for a thorough assessment by a physician, an anaesthetist, a physiotherapist and an occupational therapist at the PRIME Clinic.

The PRIME Clinic

If you are over 65 and have other health conditions, you may be asked to attend the PRIME Clinic for an in-depth medical and anaesthetic assessment. You will also meet with a specialist physiotherapist and occupational therapist who will provide advice on preparing for surgery and your discharge. The PRIME Clinic aims to optimise your fitness for surgery, reduce the risk of post-operative complications, and facilitate a quicker discharge home.

Examples of what the PRIME Clinic can offer include:

• Reviewing and adjusting your medications to prepare for surgery.
• Liaising with your surgeon about assessment results and surgical management.
• Providing an exercise programme to enhance pre-surgery fitness.
• Ordering adaptive equipment to assist with daily activities.
• Offering practical suggestions for home adjustments to improve safety.
• Coordinating with your GP regarding medication changes, ongoing tests, or social care needs.
• Referring you to community services such as:
  • Falls prevention schemes
  • Community exercise groups
  • Community physiotherapy or occupational therapy

Fit 4 Surgery

Patients who are due to have major surgery are invited to attend Fit 4 Surgery. Fit 4 Surgery is a group session led by consultant anaesthetists, physiotherapists, and specialist nurses, with input from other health professionals such as surgeons and dieticians. Fit 4 Surgery will help you understand how to improve your health and fitness before your operation, what to expect during your hospital stay, and how to continue your recovery successfully at home. During the session, you will have the opportunity to access additional information, ask questions, and share experiences with others who are also preparing for major surgery.