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The Anaesthetic Assessment Clinic is run by a team of Consultant anaesthetists, preoperative nurses and healthcare assistants. It was established in February 2005 to enable high risk, elective surgical patients with multiple co-morbidities, to benefit from having a thorough anaesthetic assessment before undergoing surgery. We are able to carry out simple functional tests within the clinic, and with the wealth of medical and surgical specialities and facilities on site at St George’s we are able to promptly and directly refer for further advice, formal reviews and specialist investigations.
Advice is also given regarding the appropriate level of post-operative care, ensuring that an HDU or ITU bed is arranged when required.
The consultant anaesthetist will also liaise with the anaesthetist caring for the patient to ensure they are fully appraised of the patient’s history to facilitate the planning of perioperative care. The clinics are also our opportunity to sit and discuss perioperative risk with the patient and their relatives, helping our patients to make informed decisions about proceeding to surgery. One of the risk calculators that we use currently is the American College of Surgeons National Surgical Quality Improvement Programme (ACS NSQIP) risk calculator tool to explain risk numerically to patients. This is the largest pan surgical speciality validated tool developed on US population data.
The clinics run daily in the Preoperative Centre, Willow Annexe A on the perimeter road. Referrals are made by the surgical teams or directly from the nursing pre-assessment clinic.
Since November 2017 we have been running a weekly Surgery School session (“Get Set 4 Surgery”) for patients presenting to St George’s for major cancer surgery. This is a year long pilot supported by the Macmillan and St George’s Partnership and aims to provide helpful prehabilitation advice and support to our patients in order to improve their recovery and outcomes. Our vision is to continue this service long term within cancer surgery whilst also expanding this to our non cancer surgical patients.