Preparation for surgery at Gloucestershire Royal Hospital or Cheltenham General Hospital

Please keep your leaflet safe

When you are notified of your surgical date, please read your medication instructions on page 6 to remind you of any advice to stop taking certain medications.

Important information for you to read before your admission

If you need to contact your pre-operative assessment nurse, please telephone:

Reception: 0300 422 2559 or Nurses: 0300 422 4700

Blood tests before admission

You may need to have a blood test in the Edward Jenner Clinic at Gloucestershire Royal Hospital or West Block Outpatient Department at Cheltenham General Hospital before admission. If so, you will be given a form or forms for this.

Your healthcare professional advise when to attend your blood test, the name of your surgical operation, the date of admission for the operation, and your expected length of stay.

Preparing to come into hospital

It is important that you are prepared for being in hospital and away from home. Here are some points for you to think about:

• Have you arranged who will bring you into hospital and take you home again?
• If you are having a day case procedure and have not arranged for someone to be with you for 24 hours after surgery, you are at high risk for cancellation on the day of surgery. You will need a responsible adult to stay with you for 24 hours following your discharge.
• Patients who have a package of care may need to contact their provider and adult social services before their surgery date to inform them that their package of care may need to be adjusted for their recovery period.
• Who will help you with your shopping, or do it for you?
• Do you need to top up your freezer (if you have one) and cupboards to reduce the amount of shopping that needs to be done after your operation?
• If you have any pets, who will care for them while you are in hospital?
• How will you manage when you go home from hospital? Do you need to move things in your home for safety reasons? Do you need to move items so they are easy for you to reach?
• Do you need to have your usual repeat prescription topped up to avoid running out of medication soon after your discharge?
• Have you got basic pain relief medication in the house such as paracetamol and ibuprofen? These are not routinely supplied by the hospital when you are discharged.
• Make sure you have all your important contact details to hand such as your GP’s surgery and hospital department, in case you need to contact someone after your operation.
• Make sure you have read and understood any leaflets about your operation, especially the sections about what to expect after surgery.
• If you have any additional needs, these should be discussed with hospital staff before your admission. Please contact your pre-operative assessment nurse on the telephone number written in the front of this booklet.
• If you have any worries or concerns before or during your stay, please speak to a member of staff.

The day of your surgery

Medication

Please follow any additional instructions given at your Pre-operative Assessment Clinic (POA) appointment as certain medications need to be omitted (not taken) on the day of surgery. See the further instructions section below. You should take all other routine medication as usual. Tablets can be taken with a small amount of plain water.

Fasting (nil by mouth)

Please follow the instructions written in your ‘To Come In’ (TCI) letter.

If you have been given specific food or bowel preparation instructions it is important that you follow them carefully. If you have not been given specific instructions, please speak with your healthcare professional.

If you have been asked to arrive before 11am

There is no benefit to fasting for longer periods of time, it may be harmful and delay recovery.

Personal hygiene

Have a bath or shower (or good strip wash) on the day of your operation. This is to stop any unwanted bacteria coming into hospital with you and to reduce the risk of infection. If you are unable to do this, please have a bath or shower (or good strip wash) the evening before and sleep in clean bedding and nightclothes.

What to bring to hospital?

Please bring the following items with you in a small bag, such as a sports bag:

• Your current medication, including inhalers, in their original labelled packs along with a written list of all the medicines that you take including the doses.
• If you have X-rays, MRI scans or other recent investigation results carried out in another hospital then please bring these with you.
• Wear comfortable, warm clothing and secure footwear such as slippers that support the heel of your foot and are not loose.
• Overnight items such as nightwear, a towel, a tooth brush and toothpaste (please ask relatives to bring in any additional items when they visit).

Possible risks of cancelation on the day of surgery

If you have any questions about your surgery, please contact your surgeon’s secretary via the Gloucestershire Hospitals Switchboard on 0300 422 2222. When prompted, ask for the operator, then ask to be put you through your consultant’s secretary.

If any of the following reasons apply to you, please contact the Pre-assessment Unit on 0300 422 4700.

Possible reasons of cancelations:

• If you are recently pregnant.
• You are unwell with a cold and flu like symptoms (fever).
• You have an infection or have recently recovered from an infection since your pre assessment (urinary, chest or skin).
• You are breast feeding and would like further advice.
• You have been admitted to hospital since your preassessment.
• You have had another surgical procedure since your pre-assessment (you may need further tests).
• There are changes to your health or you have been prescribed new medication since your pre- assessment.
• You no longer wish to have surgery and would like to ask further questions.
• You have forgotten to follow your pre-assessment advice to stop certain medications before or on the day of the surgery.

Smoking

Please be aware that smoking is not allowed anywhere in the hospital buildings or grounds.

We want you to have the best possible outcome from your surgery. Giving up smoking before or during your hospital stay can speed up your recovery and help reduce the risk of complications.

It is never too late to stop smoking and there is plenty of support available to help you. To find out more, please contact your GP. Alternatively, you can contact Healthy Lifestyles, Gloucestershire. The details are at the end of this page.

Body mass index (BMI) and obesity

We know that people living with obesity can sometimes be treated unfairly. You should not be treated differently or feel at a disadvantage because of your weight. Obesity is a medical condition. It can increase the risks linked to surgery. We will talk with you openly about these risks so you can be involved in decisions about your care.

If your BMI is over 35, we may advise you to make some lifestyle changes before your surgery. This may include eating a healthier diet or being more active, if you are able to. This can help you lose weight and may lower your risk during and after surgery.

For more support, please see the further information section at the end of this page. It includes our webpage and referral information for Healthy Lifestyles Gloucestershire.

On arrival at the hospital

• A relative, friend or carer can escort you to the department but will be asked to leave shortly after arrival unless you have additional needs and require their support. This will need to be arranged with the day surgery sister before your admission date. Before leaving, your relative, friend or carer will be asked to give us their telephone number(s) so that we can contact them if needed. They will then be given the telephone number of the ward you will be going to following your operation, an approximate time to ring as well as the visiting times.
• The day surgery units at both Gloucestershire Royal and Cheltenham General Hospitals open at 7:30 am so please do not arrive before this time. Please note. Both of the day surgery units close at 21.00, no patients stay overnight on the units.
• On arrival at the unit, you will be greeted by the reception staff who will take your details and book you in. You will then be asked to wait for the nurse.
• You will be shown to either an admission cabin or a trolley space to be admitted by the nurse looking after you. The nursing staff will take your blood pressure, check a few other details and apply your identification bracelet.
• Once fully admitted you will be asked to change into a theatre gown. Your clothes can be placed in your bag and this will be labelled with your name and hospital number. If your operation is not first on the list, you may be asked to change at a later time.
• You may like to bring a book or magazine to read while you are waiting for your surgery.
• The anaesthetist and surgeon will meet you and discuss your anaesthetic and operation. This may be in a private cabin or trolley space with the curtains drawn around you.
• If you are not able to walk very far, a wheelchair will be available to take you to the admission area and then on to theatre.
• A nurse or member of the theatre staff will go with you to the operating theatre when it is your turn for surgery.
• If you are to remain in hospital overnight following surgery a ward bed will be identified for you to go to after your operation.
• You will be asked to lie on a trolley in the theatre area before going to the anaesthetic room. Your identification will be checked by an anaesthetic assistant.
• The nurse will take any personal items you still have with you such as your dentures and hearing aids and place them in the ‘dignity’ box you will have been given. These will be returned to you in the recovery room or put with the rest of your belongings and taken to the ward you will be going to after your operation.

In the event of your operation being cancelled

Gloucestershire Hospitals NHS Foundation Trust try very hard not to cancel operations on the day of surgery. However, if this happens, we will aim to give you a new date for surgery before leaving.

If your surgery is cancelled, your friend, relative or carer will be telephoned to come to collect you. You will be given something to eat and drink before leaving.

Planning your discharge from hospital

It is very important that you plan your transport home as you will be unable to drive for 24 hours following your surgery. You should arrange for a relative or friend to collect you from the unit and for someone to stay with you for 24 hours following the surgery if you are a day case patient.

If you are having surgery in Gloucestershire Royal Hospital, please expect that you may be transferred to the Discharge Lounge on the day of your discharge.

The Discharge Lounge is located on Mayhill Way, next to the Women’s Centre. Your family can collect you directly from the lounge. There are dedicated collection spaces outside and there is no charge for parking.

You can travel home by taxi but you will need someone to accompany you.

The Red Cross can arrange transport home. If needed, please contact them on:

Tel: 01235 552 665 or

Email: ilcrsouthciadmin@redcross.org.uk

Early planning can make sure you are able to go home as soon as your consultant is happy with your progress.

Further information

If you have internet access you may wish to visit www.gloshospitals.nhs.uk.

This is the Gloucestershire Hospitals NHS Foundation Trust website which gives ward information, maps of the hospital sites and patient information pages.

Enter Pre-operative assessment in the search box to view more information about the clinic.

Alternatively, type www.gloshospitals.nhs.uk/our-services/services-we-offer/pre-operative-assessment-clinic/ into to your internet browser.

Royal Collage of Anaesthetists (RCOA)

Website: www.rcoa.ac.uk/fitterbettersooner

This site has lots of information about how to prepare yourself before your operation to enable a better recovery. It also has information on the most common operations performed in the NHS.

Healthy Lifestyles Gloucestershire

Help and information about giving up smoking.

Tel: 0800 122 3788

Website: https://hlsglos.org