Every patient admitted to the hospitals in which I work is asked to complete an audit form. These are
analysed and ranked by an independent company and provide valuable insight into how well we are
performing. One of the commonest issues raised is the admission process and although this is not
directly related to my specialty I thought it worth doing a blog to help future patients:

Some patients complain that the admission process has been rushed whilst other patients
conversely complain that they were kept waiting. As with a lot of medicine the reason is false
expectation. Many patients are given an actual time for their operation but this can only be an
estimate. Even the first operation in the morning can be delayed because we may be waiting for
instruments to be delivered, because emergencies need to take place, because of other issues on
the ward or occasionally because staff are held up due to problems with public transport. As the day
goes on each operation can create further delays and the time we take with a particular operation
varies considerably. As a result any operation time given to patients in advance is almost always

I am as frustrated as anybody else when I go to a hotel or get to the airport for a flight and have to
wait, but an operation is a totally different matter. We don't need to just check that you are the right
person and have the correct ticket, we need to prepare you for an operation and to ensure the
highest level of safety. The nurses and doctors need to take a medical history, examine you, and
check the best part of 100 different items to minimise risk and to keep you safe. We may need to
take blood or perform an ECG or other tests. If we rush this process we are not being fair to you the

Equally important, if you are having a general anaesthetic or sedation, is the need to ensure that you
are relaxed and mentally prepared for your operation. Only a few years ago patients were routinely
admitted the night before any operation. Massive advances in anaesthetic drugs and techniques –
not surgery – allow us to admit many patients on the day of the operation but if a patient arrives in
the anaesthetic room rushed with high blood pressure and a fast heart rate it is not only distressing
for them but can actually be dangerous

Ideally all patients should arrive at the hospital at least two hours before their operation. I like my
patients to get changed and unpacked as soon as they arrive and I ask my nursing staff to undertake
the checks as early as possible. That then gives time for my patients to relax, read a book or watch a
film, or just chat to their relatives so they are relaxed and calm for the start of their anaesthetic. Far
from being wasted time keeping the patient waiting this is a vital part of safe anaesthetic practice

Of course no system is perfect and it isn't always possible for patients to arrive two hours before
their operation – a good example is the first patient in the morning when we start operating at 7 30.

However, I would advise you to arrive at the hospital in good time and to give yourself a margin of
error in case your journey is delayed. Bring an iPad or book with you to relax in your room. If you
find the admission process is relatively short, do not be alarmed or get upset as the nurses will be
doing their best and will professionally make sure you are safe