Pre-Op Assessment – Again

I am very grateful to be treated on the NHS.  When dealing with the anxiety of facing surgery, it is comforting not to be facing financial ruin at the same time.  Nonetheless, my inner control freak/process nerd is protesting at the confusion accompanying the pre-op assessment process.

As I mentioned in an earlier post, for some reason, my pre-op assessment was scheduled nine weeks and six days before my surgery date.  Having previously experienced the need to repeat my MRSA screening test three times before having a cortisone injection last year, I was well aware that the shelf-life of these tests is finite and fixed at a maximum of six weeks.

Hence, I asked the question at my original pre-op assessment.  I was told that “probably” some of the tests would have to be repeated.

As the calendar advanced to mid-November, and my tests approached their seven-week birthday, I heard nothing.  Determined that my operation should not be cancelled because of an expired MRSA screening test, I asked the question several more times.

I asked the person who answered the pre-op assessment team phone number I had been given.  She said I would probably be all right, but just to be sure she would put my call through to someone else.  She transferred me to the admissions department so I asked again.  I was told I would probably be all right, but then again, I might not be.  I tried really hard to understand what I was being told.  It didn’t work.  Even when I asked, “so what exactly should I do now?” I listened attentively, but could not decipher a clear instruction.

Then, last week, three letters came in the post on the same day from the hospital.  Two chunky letters, which were exact duplicates, confirmed that I was ‘passed fit’ for surgery and should appear at 7am on my scheduled date.  The third letter instructed me to attend the pre-op assessment clinic to have all my pre-op tests repeated.

I found this a little confusing.  So I rang the pre-op assessment team again.  They assured me I was passed fit for surgery and did not need to repeat any of the tests.  I would like to say I’m a trusting soul, but the nagging voice inside made me ring the number on the other letter just to be sure.  From the other department, I was told that they weren’t really sure, but it would be best if I came in to repeat the tests.

So, on Tuesday, after an interesting Board seminar on risk management at the NHS Community Trust where I am a Non-Executive Director, I raced up the M6 to make my appointment on time.

As I’m in process nerd mode, I will digress to comment on the car parking at the hospital.  Every time I go, there is a cluster of irate patients gathered at the pay and display machine railing at the inadequate facilities, the miniscule spaces adequate only for rickshaws or Smart Cars (both notoriously absent), the charges, the scheduling of appointments which seems to create fierce competition for spaces at peak times, and the distance and terrain from car park to hospital entrance.

When I say “railing” I mean this in the British sense, of course.  There is low-decibel, almost inaudible, grumbling, there is faint tooth sucking, there is head shaking, there is the shared look that passes between fellow sufferers indicating, “I could really do without this just now.”

Despite patients’ seemingly endless capacity to endure inconvenience, this really is poor.  I hate myself for getting into this subject, but I have started now.  Can there be any excuse for a hospital that prides itself on being a specialist centre of excellence for orthopaedics offering such abysmal parking facilities to patients – almost all of whom struggle with mobility?

Anyway, my parking karma was working for me on the day, and I managed to find a space after just three vulture-like sweeps of the car park (hurrah) but then despaired that I had the wrong change.   The machine does not accept 10p coins.  My frantic search of the car, my handbag and my coat pockets was fruitless.  I joined the clucking group by the machine and was offered a bountiful supply of 20p coins in exchange for my useless 10p coins by experienced veterans who came prepared.

As I was limping down the hill toward the hospital, I saw one of my 20p providers remonstrating with the parking warden.  She was cross that a driver, who was unable to fit a normal sized-car into the tiny space allotted, had opted to park horizontally across three spaces. She also added a cutting observation about confused priorities in that the hospital has chosen to invest in a warden to police car parking charges rather than provide adequate facilities in the first place.  She was right.

When I got to Ward 4, it seemed I was indeed expected, and my chunky file was there on the trolley by reception.  The nurse I met was delightful – kind and reassuring – and equally confused as to why I was originally called in so far in advance of my surgery date.  She reported the good news that only some of my tests had to be repeated.  It seems that EKGs, height and weight tests last longer than MRSA, urine and blood tests.  There you go.

I repeat my previous observation that this type of experience – potentially multiplied by hundreds of patients at just one hospital – seems so unnecessarily wasteful of resources when the NHS is under financial pressure.  I am not a logistics expert, but I suspect sorting out these processes would be pretty straight-forward and would bring some welcome clarity for patients and staff.

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