What can I do to prepare for my surgery?
Smoking cessation - stopping smoking before your operation can greatly reduce the risks linked to surgery and help your recovery.
The time leading up to your surgery can be a good opportunity to think about making positive changes to your health:
- You may feel more motivated to improve your wellbeing at this stage.
- You will have opportunities to speak with healthcare professionals who can offer advice and support.
- Being in hospital means you will be in a smoke-free environment, which can help you cut down or stop.
- Many people say that advice from healthcare staff plays an important role in their decision to quit.
- Hearing these messages more than once can make it easier to take that step.
Stopping smoking can also improve your overall health and reduce the risk of complications, particularly if you already have other health or social challenges.
Making this change now can benefit both your surgery and your long-term wellbeing.
Free Quit plan - https://www.nhs.uk/better-health/quit-smoking/ready-to-quit-smoking/personal-quit-plan/
Lancashire Teaching Hospitals NHS foundation Trust Information for patients and carers – An i9nformation leaflet for smokers https://www.lancsteachinghospitals.nhs.uk//media/.leaflets/6555e7263bbe48.88892233.pdf
Exercise – Keeping activity is important whilst waiting for surgery – below are some helpful tips. https://cpoc.org.uk/guidelines-and-resources/perioperative-optimisation-Top-seven-interventions/exercise Jo Wicks videos
Alcohol moderation - Cutting down on alcohol before surgery can help lower the risk of problems. People who drink too much alcohol are more likely to be undernourished and may have complications such as infections (especially chest infections), bleeding, irregular heartbeats, and confusion after surgery. They may also take longer to recover.
National advice says that both men and women should drink no more than 14 units of alcohol a week. This should be spread out over at least three days, not all at once. Drinking is considered harmful if it is more than 35 units a week for women or 50 units a week for men. For more details on units, see the alcohol unit guide above.
Drinking can become a habit, and habits can be hard to change. Here are some simple tips to help cut down before and after surgery:
- Have some alcohol-free days each week to let your body recover
- Be aware of what makes you want to drink
- Set a start date to reduce your intake
- Change your routine or surroundings if needed
- Try alternatives like fizzy water with fruit or low-alcohol drink
Ensuring mental wellbeing - Mental health and surgical preparation
The connection between mind and body is important when preparing for surgery. Mental health conditions can affect recovery, sometimes leading to longer hospital stays and a higher risk of complications. Supporting mental wellbeing before surgery is not only about feeling better emotionally, but also about improving physical recovery.
Surgery is not only a physical experience—it can also be mentally challenging. It is normal to feel anxious or stressed beforehand. The following tips may help to manage these feelings:
- Take time for yourself and practise self-care
- Stay as active as you can
- Aim to eat a healthy, balanced diet
- Try to limit alcohol intake
- Stay connected—talk to family and friends
- Spend time outdoors and get some fresh air
- Practise relaxation techniques such as meditation, breathing exercises, or visualisation
Taking small steps to support your mental wellbeing can make a positive difference to your overall surgical journey. https://cpoc.org.uk/guidelines-and-resources/perioperative-optimisation-Top-seven-interventions/mental-wellbeing
Nutrition – A balanced diet is essential for improving overall health from the inside and reducing the risk of complications such as infections and delayed recovery after surgery. Here are six simple nutrition messages for everyone:
Include plenty of fruit, vegetables, nuts, and oily fish (or suitable alternatives) to ensure adequate intake of vitamins and minerals.
Make sure you consume enough protein, as it supports healing and recovery.
Stay well hydrated by drinking sufficient water.
Being overweight increases surgical risks. While weight loss can be challenging, it can be supported by:
reducing portion sizes
reviewing how often you eat
choosing healthier types of food
Limit or avoid processed foods.
Achieving better nutrition - https://cpoc.org.uk/guidelines-and-resources/perioperative-optimisation-Top-seven-interventions/nutrition Eat well - https://www.nhs.uk/live-well/eat-well/ British Dietetic Association - https://www.bda.uk.com/resource/healthy-eating.html
Managing chronic illnesses
Diabetes - If you have diabetes, it is essential to keep your blood sugar levels well controlled before your operation. Poor control can lead to slower wound healing and increase the risk of complications after surgery. In some cases, if blood sugar levels are not well managed, your procedure may need to be postponed. Diabetic services RPH -https://www.lancsteachinghospitals.nhs.uk/our-services?service=23
Anaemia - Anaemia is a condition in which the number of red blood cells in the blood is lower than normal. Having adequate levels of red blood cells and iron is important for healing and recovery following surgery. As treating anaemia can take several weeks, it is important that it is detected as early as possible.
If you are found to be anaemic, treatment may include:
- Iron tablets
- Iron given through a drip into a vein (intravenous infusion)
- A blood transfusion (less common) https://www.nhs.uk/tests-and-treatments/blood-transfusion/
Practical preparation - In the days before your surgery, plan how you will travel to and from the hospital and decide what to bring with you.
Be sure to inform family and friends well in advance so they can arrange time off work to support you if needed. Please use the links below to access helpful information. https://www.lancsteachinghospitals.nhs.uk/ https://www.lancsteachinghospitals.nhs.uk/supporting-patients-waiting-for-hospital-treatment
Simple steps to keep you safe during your hospital stay - Keeping you safe and well while in hospital is a priority for the staff looking after you. The link below provides simple steps to help ensure your safety during your hospital stay -https://www.lancsteachinghospitals.nhs.uk/simple-steps-to-keep-you-safe-during-your--hospital-stay
Next steps - The Hospital will contact you ahead of your admission with further instructions.
Travel arrangements - Plan how you will get to and from the hospital. You will not be able to drive yourself home after surgery, so arrange for someone to collect you or organise alternative transport. In some situations, the hospital may be able to assist with transport home.
The link below provides parking information and charges. https://www.lancsteachinghospitals.nhs.uk/car-parking
If you need to cancel - If you are unable to attend your appointment or feel unwell before your surgery, inform the hospital as soon as possible so your procedure can be rescheduled.
You should also contact the pre-operative assessment, if you develop symptoms such as a cough, cold, or fever in the days leading up to your operation.
They will advise whether it is safe to proceed on:
Central Pre-Operative Assessment - 01772 522922
Orthopaedic Pre-operative Assessment - 01257 245517 or 01257 245423
Ophthalmology Pre-operative Assessment - 01257 245034
Gynaecology Pre-operative Assessment - 01772 52438
Assessment, optimisation, shared decision making – You can find helpful, easy-to-read leaflets from the Royal College of Anaesthetists. Use the link below to learn about the risks of surgery and support your decision-making. https://www.rcoa.ac.uk/patients/patient-information-resources/anaesthesia-risk/risks-associated-general-anaesthesia
Read more:
Check out our Anaesthetic patient information leaflets: https://www.lancsteachinghospitals.nhs.uk/patient-information-leaflets
Centre for Perioperative Care - information for patients: https://cpoc.org.uk/guidelines-and-resources/guidelines-resources/resources/patient-information-leaflets
Set for Surgery patient information leaflet: https://www.lancsteachinghospitals.nhs.uk//media/.leaflets/68fa01b4ed50f0.23550992.pdf
Preparing for your operation Information for patients: https://www.lancsteachinghospitals.nhs.uk/media/.leaflets/6a313666dba4d9.31078123.pdf
Preoperative Assessment
The role of preoperative assessment
We assess your fitness for surgery and provide the information you need to help you prepare for your procedure.
If you are listed for an operation, you must have your pre-operative assessment to be able to safely proceed with your surgery.
There may also be an opportunity to see an anaesthetist during your visit – this may happen at the same time as your initial visit or at another time.
We have preoperative assessment clinics at both our hospital sites – where you have your appointments can depend on the procedure you are having but there may be an opportunity to choose a site that is most convenient to you.
Health questionnaire
When you are listed for an operation in the surgical outpatients we will send you a link via email or text, to take you to an electronic patient assessment questionnaire (ePAQ).
Please refer to the LTHR Surgery School Electronic Patient Assessment Questionnaire (ePAQ) video below for further information.
This form provides details about your current health and previous surgeries, as well as allowing you or your loved ones to voice any concerns you might have about your upcoming surgery.
You will be able to complete the questionnaire on a PC, tablet, or smartphone and usually takes about 20 minutes to complete. If required a carer, friend or family member can help you fill the questionnaire in.
It is important that you complete the questionnaire so that we can plan what you need for surgery.
What happens next?
Unfortunately waiting times for operations vary widely and there may be some time between completion of the questionnaire and being given your operation date.
The questionnaire will be reviewed by our Perioperative Care Coordination Team who will decide what is the most appropriate preoperative pathway for you. They may contact you or your GP regarding any chronic health conditions that may impact your recovery from surgery. They can also offer signposting and support with regards to any modifiable lifestyle factors – these will be specific to you and your local area. They use a location based signposting tool to support the advice they provide.
The team will also check in with you regularly to encourage you with any lifestyle improvements.
Depending on which pathway you are on you will be contacted by the team and they may arrange for you to talk to one of our nurses over the telephone or you may be asked to come into our clinic to see one of our nursing team and/or one of our anaesthetic team to further discuss your health and how this may affect your risks from surgery.
Your visit may include having tests, so please be prepared to spend up at least a couple of hours during your appointment.
In addition to some routine blood tests, some other tests might be required. These include
- Electrocardiogram (heart tracing)
.jpg)
- Echocardiogram (heart scan)
.jpg)
- Spirometry / Pulmonary Function test (breathing test)
.jpg)
- Cardiopulmonary Exercise Test
Please watch the LTHTR Surgery School CPET video for additional details:
If these are indicated, you will be informed either at your appointment with the nurse or later once your notes have been reviewed by a member of the anaesthetic team.
Before your appointment
Check to see what you might need to bring or do below:
- Eat and drink as normal before you attend your appointment
- Check your appointment letter to see if you need to prepare anything
- Please note that patients under 16 years of age must be accompanied by an adult
- Your appointment letter
- A list of current medication that you take, including their strength and how often you take them – your GP prescription should show this information clearly
- Any samples that have been requested
- A list of any relevant medical conditions or surgical procedures you have / have had
- Questions you may have about your surgery or anaesthetic.
- Change for car parking charges
- If you have a medical alert card or medical implant e.g. pacemaker, it is important to bring these details with you to show the nurse.
- We make every effort to ensure that patients are seen at their appointment time, however this is not always possible, as it is difficult to predict how long each patient will need to spend with the nurse.
For more information, please see the LTHTR surgery school video on What happens at your pre-operative assessment:
During your appointment, you may have some of the following checks:
-
General observations - These are simple measurements used to assess your overall health:
- Blood pressure: A cuff is placed around your upper arm and gently inflated for a few seconds. You may feel some tightness. It is important to keep still and quiet while the reading is taken.
- Pulse and oxygen levels: A small clip is placed on your finger (or sometimes your ear). This quickly measures your heart rate and oxygen levels without any discomfort.
- Body measurements
- Your height and weight will be recorded.
- You will be asked to stand upright while a measuring device is used.
- Heart tracing (ECG)
- This test checks your heart rhythm.
- Small sticky sensors are attached to your chest, arms, and legs.
- It is painless and usually takes around five minutes.
- Not everyone will need this test.
- Blood test
- A small sample of blood is taken from your arm using a needle.
- A band may be applied to make the vein easier to locate.
- You might feel a brief scratch or sting.
- Afterwards, pressure is applied and a plaster may be used.
- Please let staff know if you feel uneasy about needles.
- Infection screening swabs
These tests check for bacteria that may need treatment before surgery:- MRSA swab: Taken from your nose and groin using a soft swab. This is quick and not painful.
- If any results are positive, you will be contacted and given treatment before your procedure.
- Urine test – (for specific surgery)
A sample of your urine will be checked for signs of infection or other conditions.
- Breathing assessment (spirometry / pulmonary function test)
- This evaluates how well your lungs are working.
- You will be asked to blow into a mouthpiece connected to a machine.
- The test may take up to 30–40 minutes, and results are printed as a chart.
What do I do if I have reasonable adjustments?
When the team contact you to arrange the appointment they will establish if you have any special requirements or reasonable adjustments. They can then arrange the most appropriate appointment for you and ensure the team on the day are aware and make any necessary arrangements. This may include having an interpreter for the visit. Please note that friends and relatives are not permitted to interpret for you during your assessment.
