A leading group of professional healthcare organisations including the Centre for Perioperative Care, the Royal College of Surgeons of England and the Royal College of General Practitioners, have today launched new guidance which will boost the NHS in its efforts to provide better advice, support and care to patients contemplating or waiting for surgery.
Major surgical complications already affect over 300,000 NHS patients per year, jeopardising long-term quality of life and survival. With the pandemic leaving five million people currently waiting for planned surgery, without action, the rate of major complications may rise due to deteriorating health and fitness while waiting.
The new ‘Pre-operative assessment and optimisation’ (POAO) guidance supports clinicians to help patients turn their waiting list into a preparation list, by taking this time to get ready for their surgery and improve their health.
Embedding shared decision making into perioperative care pathways, as described in recent NICE guidance, is recommended as an important step to ensure patients get the right care for them, every time.
Innovations such as prehabilitation, which includes improving general health, exercise, nutrition, and preparing patients psychologically, all help to support people waiting for surgery.
Establishing reliable systems to ensure patients remain in contact with surgical and perioperative services while on waiting lists, will protect patients and reduce health inequalities. Such systems will make sure patients feel supported and highlight any deterioration quickly so that this can be taken into account when planning for their procedure.
Professor Ramani Moonesinghe, author and chair of the guidance report and Professor of Perioperative Medicine at UCL said: “We are all aware that the COVID-19 pandemic has had a substantial impact on waiting times for non-urgent treatment. If implemented in full, these guidelines will support the recovery of elective NHS services, help achieve key aims of the NHS Long Term Plan such as reducing health inequalities and preventing serious illness, and crucially, will support patients to get better outcomes from surgery.”
Mrs Scarlett McNally, surgeon and Deputy Director of the Centre for Perioperative Care said: “This is a chance to improve each of the small factors that make up perioperative care. It is about empowering patients, defining pathways and educating staff so they can all detect problems where interventions are proven to work. What is better for patients Is better for the service and the staff. It really is a win-win.”
PDF of guidelines: Preoperative assessment and optimisation guidance.pdf