Improving your care while waiting for surgery
North Bristol NHS Trust (NBT) wanted to find out what people on waiting lists for surgery thought was working well and what could be improved. NBT particularly wanted to hear from those most likely to face health inequalities, such as disabled people, neurodivergent people, people on lower incomes, people from minority ethnic groups, and LGBTQ+ people.
NBT commissioned Healthwatch to carry out this work because of our expertise in collecting feedback and our connections with local communities - including groups more likely to have a poor experience of healthcare.
NBT's goal is to improve people's experiences. Find out what patients told us in our latest report or watch the video below.
North Bristol NHs Trust action plan
Pre-rehabilitation approach
People on waiting lists told us they wanted holistic support. This means looking at all the factors that impact someone, such as their social support, finances, housing, and arrangements for their discharge from hospital. This should be done before - rather than after - their surgery. NBT is piloting a questionnaire about people's personal needs to gain a better understanding of what support people may require.
NBT is also working with community providers to identify patients with complex discharge requirements. This means people will have the support they need when it comes to being discharged from hospital after their surgery.
Better/more frequent communication
In line with NHS Elective care 2023/24 priorities:
- 'Patients waiting for in-patient procedures should be contacted by their provider at least every 3 months.'
- 'Patients identified as having risk factors for poor perioperative or surgical outcomes should receive proactive, personalised support to optimise their health before surgery.'
NBT are trialling texting people to check that they still need surgery.
Communication in a way people can understand
The NHS Accessible Information Standard says that people's preferred means of communication must be clear and recorded in their notes. This can be done via electronic flags or alerts, or paper-based equivalents.
These alerts tell healthcare staff that someone has an information/communication need, so that staff can make sure these needs are met.
NBT has Accessible Information Standard alerts in place and is part of the local Accessible Information Standard steering group.
Case study
Diane has autism spectrum disorder and a long-term health condition. She has limited family and social networks and describes herself as living in poverty. Diane’s additional needs have been flagged by the hospital and she said that she has an autism passport in her medical records, designed to communicate her needs to doctors, nurses and other health professionals.
Her surgery was due in January 2023. At a pre-operative assessment a month before, she was given new information about the details of her operation that scared her, causing her to cancel at short notice.
At a subsequent appointment having had time to process the pre-operative information that had scared her, she asked to be put back on the list. She finally had a chance to discuss it with her consultant in September 2023 and received confirmation that she was back on the list in November 2023, almost a year after her pre-operative assessment.
Diane can understand correspondence on her own but likes to take a friend or her social worker with her to appointments. Diane said at one of her appointments she had to point out that her autism passport was out of sight at the back of her notes, so thinks her needs had not been pre-empted in advance of her appointment.
Information in one place
Patients awaiting surgery would like to be directed to a evidence-based information and a range of recommended sources with links to these in one place.
There is a website page with information about preparing for an operation, and NBT has also said it will continue to work on resources for those who are digitally excluded e.g. are not confident using the internet.
Posters about preparing for an operation are displayed in the majority of outpatient settings.
Local, community, in person support
NBT acknowledges that online support should complement, but not replace, the role of community, in-person support; Social Prescribing; and personalised needs assessments.
Ways of doing this include raising awareness of services that are available regardless of someone's place on a waiting list, providing information on a new webpage of the services available, and making sure both GPs and NBT have access to social prescribers.
Are you on a waiting list for surgery? Share your feedback about the experience with us by clicking the pink 'Talk to us' button below and completing our online feedback form.
