Pre-Assessment
CONTENT UNDER REVIEW
Who We Are
We are a multi-disciplinary team based at Ninewells Hospital, Perth Royal Infirmary and Stracathro Hospital, covering the whole of NHS Tayside. The team consists of pre-assessment nurses, advanced nurse practitioners and a number of Consultant Anaesthetists with an interest in perioperative medicine.
What We Do
We aim to provide a collaborative, patient-centred, multi-disciplinary approach from the moment surgery is indicated to full recovery. This includes:
• Risk assessment/suitability for surgery (encompassing shared decision making)
• Comorbidity management and optimisation
• Lifestyle optimisation
• Complex pain management/planning
• Support with rehabilitation
• Support with nutritional optimisation
• Awareness to anaesthetic staff of a particular patient prior to the day of surgery
• Risk assessment/suitability for surgery (encompassing shared decision making)
• Comorbidity management and optimisation
• Lifestyle optimisation
• Complex pain management/planning
• Support with rehabilitation
• Support with nutritional optimisation
• Awareness to anaesthetic staff of a particular patient prior to the day of surgery
Who to Refer
This service is for patients for planned surgery. We are happy to take referrals at any stage in the perioperative journey, from initial presentation in general practice right through to the surgical clinics. Even if the patient hasn’t yet definitely been listed for an operation, we can support risk assessment suitability and decision-making.
We have a few different streams for patients, depending on what criteria they meet, and will usually either see them in our frailty clinic or our consultant clinic. We will triage all referrals within two working days, and decide on the best fit for them.
Examples (not exhaustive) of reasons for referral. Please ask if you’re not sure:
Frailty
Over 65 and
multiple morbidity (two or more medical conditions), frailty (Clinical Frailty Score 5 or more), complex needs (any functional dependence) or difficulty with decision making (cognitive impairment)
Increased risk without frailty
Complex chronic pain needs/management
Severe respiratory or cardiac disease
Difficult decision-making
Uncertainty about whether surgery is the right course of action for this particular patient.
We have a few different streams for patients, depending on what criteria they meet, and will usually either see them in our frailty clinic or our consultant clinic. We will triage all referrals within two working days, and decide on the best fit for them.
Examples (not exhaustive) of reasons for referral. Please ask if you’re not sure:
Frailty
Over 65 and
multiple morbidity (two or more medical conditions), frailty (Clinical Frailty Score 5 or more), complex needs (any functional dependence) or difficulty with decision making (cognitive impairment)
Increased risk without frailty
Complex chronic pain needs/management
Severe respiratory or cardiac disease
Difficult decision-making
Uncertainty about whether surgery is the right course of action for this particular patient.
Who Not to Refer
This service is not suitable for patients who are in hospital under an emergency admission.
How to Refer
Via dedicated email TAY.tpot@nhs.scot
Including:
Please note that this referral pathway does not replace the usual process whereby all patients must have a PAC front sheet submitted from the surgical clinics.
Including:
• Patient’s name
• CHI
• Proposed procedure (if known)
• Reason for referral
Emails will be triaged and you will receive an acknowledgement within two working days.• CHI
• Proposed procedure (if known)
• Reason for referral
Please note that this referral pathway does not replace the usual process whereby all patients must have a PAC front sheet submitted from the surgical clinics.