"Some suggestions to improve your pre-op..."

About: Royal Preston Hospital

Yesterday, I accompanied my 85 year old father for his pre-op assessment ahead of his hernia operation which is scheduled for tomorrow.

My father is a little deaf and also gets overawed by Doctors and hospitals.

He has given me his power of attorney and I have registered this with his GP because Dad has asked me to attend all of his hospital appointments with him so I can ask questions or give information that he finds difficult to do.

He was contacted by phone one working day before his pre-op assessment and despite being clearly hard of hearing was given more information over the phone than he could either hear or understand.

It left him feeling anxious and confused.

Would it be worth checking with elderly patients if there is a family member available or contactable who could help them with the arrangements?

Written information followed quickly which is good, but it was disjointed and difficult to follow.

Perhaps consider writing the letters in simple, less formal English?

The nurse we saw was friendly and kind towards my father in their manner but did not seem to be able to explain things in plain English.

The nurse did not check his understanding of any of the vast amount of 'technical' points they were discussed with him.

How confident can the nurse be of the accuracy of that information?

There was a lot of duplication. Basic information such as address etc was rewritten during the assessment. We provided a printed list from the GP of all of his medications but the nurse sat and hand wrote them out again on the form, providing another opportunity for transcription errors and omissions.

When my Dad was clearly struggling to understand a question, I asked the nurse to clarify and the nurse gave me a filthy look before pointedly turning their back on me and addressing my father in an exaggerated fashion.

Suggestion #2:

I understand that you want to be respectful to the patient and to address them directly but would it make sense to check if a power of attorney is in place or if the patient would like to include the accompanying family member in the discussion?

My Dad is 85, he's had a quadruple heart by pass, has a history of complications with COPD, takes medication for angina and a raft of other things, so a general anaesthetic is a big deal.

It seemed that the pre-op was more of tick box exercise than an opportunity to work around those complications.

Of course, we assume that the op will go smoothly but let's hope the key information needed for that was indeed collected yesterday even though input from the legally appointed representative was unwelcome.

I found the nurse's behaviour insulting and I am left anxious about potential complications during tomorrow's op.

I hope some of these suggestions are useful.

I am happy to discuss.

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Response from Rhona Hartley, Head of Patient Experience and Customer Care, Lancashire Teaching Hospitals NHS Foundation Trust

Thank you for taking the time to provide your very constructive feedback.

As a Trust, we are always seeking ways of improving our patients' experience and would welcome the opportunity to discuss some of the points you have raised in more detail. Can I ask you to please contact me on 01772 522793 at your convenience.

Many thanks.

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Response from Royal Preston Hospital

Thank you for taking the time to provide your feedback in relation to your father's pre-operative assessment. We welcome suggestions and opportunities to improve our processes and services and would welcome the opportunity to discuss the issues you have raised in more detail.

If you are happy to do so, can we ask you to please contact our Head of Patient Experience and Customer Care on 01772 522793.

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