Preoperative assessment

Photo: The Preoperative Assessment Centre waiting area

You will have a preoperative assessment if you are due to come for surgery or investigations at Chelsea and Westminster Hospital and are going to have:

• a general anaesthetic (when you are unconscious during the operation)
• a spinal anaesthetic (when an injection into your back numbs all of the lower part of your body)
• a block anaesthetic (when a part of the body is made numb)

You will not be required to have a preoperative assessment if you are only going to have a local anaesthetic (similar to the injections given by a dentist to numb a small area) unless sedation (drugs to make you relaxed and sleepy) is going to be given as well.

Why do we ask you to have a preoperative assessment?

It helps us learn about your medical history, your general health, any medicines you are taking and any previous experience with anaesthetics.

What happens at the assessment?

You will have an individual consultation with a specialist nurse who will talk through your medical history with you, arrange any tests that you need before surgery and give you information about preparing for your anaesthetic as well as certain aspects of your surgery and recovery period.

How long does it take?

Our appointments are booked for 30 minutes or 60 minutes depending on the type of surgery you are having. There may be extra time needed for blood tests or heart tests.

Why can't I have all this done on the day I come for surgery?

Our job is to help you prepare safely for your operation as well as identify any particular risks for you in having an anaesthetic. The anaesthetist looking after you on the day of your surgery needs to know as much as possible about you in order to keep you as safe as possible. If this information isn't available, the anaesthetist will not able to go ahead and your surgery would almost certainly have to be cancelled.

All this talk of risk is a bit scary, am I at risk?

Anaesthetics for the majority of patients are low risk. However, lifestyle choices can increase the risk of an anaesthetic. Being overweight, smoking, taking recreational drugs or drinking too much alcohol all increase the risk. The preoperative team will advise you on preparing for your surgery to minimise the risk.

I go to other hospitals and see different doctors as well, will this make a difference?

If you have a complicated medical history, or have had certain types of heart or lung problems, we may ask our preoperative assessment anaesthetist to review your history. The anaesthetist may decide that they need to see you in person and we will arrange an appointment for you. They may then arrange for more tests.

Won't all this delay my surgery?

It may delay your surgery for a time but it is essential that we make sure you are as safe as possible. If there are risks for you to do with the anaesthetic, we will discuss them honestly with you. Once you are ready to go ahead with your surgery, we will tell the admissions team and they will contact you with a date for your surgery.

Why can't you give me a date for my surgery?

The preoperative assessment team deals with getting you ready for an anaesthetic. The operation bookings are organised by the admissions team. We can give you contact numbers for them.

I'm fit and well and have had an anaesthetic before with no problem—
do I need to come for an appointment?

Not necessarily. We ask a set of questions when you arrive in the department. If you are fit and well, we will offer to provide you with the information you need by email or by hand. This saves your time and allows us to spend more time with people that need investigation.

I live in another part of the country—do I have to come back for another appointment?

At Chelsea and Westminster we see people from all over the country. We will work with you and your GP to arrange as much as possible while you are here and through your local surgery. However, if needed for your safety you will be asked to visit again.
If I have to come for an appointment, what information do you need to speed things up?

• We need a written list of all your medicines
• We need to know about any operations or illnesses you have had
• We need hospital numbers from any other hospitals that you visit
• If you receive copies of hospital doctors' letters about you, please bring them
• If you have a complex history we will give you a letter explaining what we need