Deciding to have surgery
Surgery at our hospitals
After you are referred to one of our services, we arrange an outpatient appointment. Your appointment might be:
- by phone
- by video call on your smartphone, computer or tablet
- face to face
People referred for cancer or suspected cancer might have their first appointment within a few weeks. People referred for other conditions usually have to wait longer to be seen.
Preparing for your appointment
Please make sure that you bring:
- a list of medicines that you take, including those you buy from a pharmacy or shop
- details of your medical history (your past and present conditions and treatments)
- a list of questions that you would like to ask
- our Making the most of your appointment leaflet
Many people find it helpful to bring a family member or friend to their appointment. You may get a lot of information and this can be overwhelming.
A trusted companion can write notes or remind you to ask about the things that are important to you. You can then concentrate on the conversation and might find it easier to take in the information.
What happens at your outpatient appointment
You meet with a member of the surgical team. The appointment might include tests, such as blood tests, scans or swabs (when we take a small sample of a substance from your body for testing).
We give you information about the surgery that we think is best for you. This includes:
- what happens during the surgery
- how you should prepare
- the benefits of surgery
- the risks of surgery
- any side effects that you might have after surgery
- what your recovery might be like
- any more care that you need after surgery
- other treatment options
If you need the information in another language or format, our language support team can help with this.
Before you leave, make sure you know:
- what might be wrong
- if you need any tests
- what treatment is best for you
- what happens next and who to contact
Older people and people with complex medical needs
After your consultation, you may be referred to our POPS team. This stands for perioperative medicine for older people having surgery.
You may be seen in our POPS clinic if:
- you are older
- you are at more risk from having surgery
- you have complex medical needs
- you need more support with making decisions
Deciding your treatment
You have the chance to talk about your options with a member of the surgical team. We tell you what we think is the best option. You can choose to say yes or no.
We want to involve you in decisions about your care and treatment. You work with the team to choose the best option for you.
It can be helpful to know about BRAN:
- the benefits
- the risks
- the alternatives (other treatment options)
- what happens if you do nothing
This video from the Centre for Perioperative Care explains more about how thinking about the BRAN questions can help you.
There's a British Sign Language version of this video that you can watch on YouTube.
Shared decision-making is a practice that encourages patients to be actively involved in decisions about what care and treatment they receive.
This is Peter. Peter's speaking to his GP about the results of a scan he's had as part of a national screening programme.
GP: “Hi Peter. Your scan shows an abdominal aortic aneurysm, a large swelling in the main blood vessel in the tummy. Going forward there's a few options for how we might treat this, including an operation.”
Peter: “Is the aneurysm dangerous?”
GP: “There is a risk that it could start bleeding and, if that happened, it is life-threatening. You could die from it.”
Peter: “Oh, it's all a bit frightening.”
GP: “It is a lot to take in. I want to reassure you that we'll support you through this. I'd like to refer you to a clinic, where you can speak to a surgeon about your treatment options.”
Peter's GP explains that it's important for Peter to be involved in making decisions about the treatment and care he will receive. Depending on your specific condition and where you live, different tools and resources are available to help guide you through the decision-making process. Peter's GP recommends the BRAN framework.
GP: “Peter, have a look at this BRAN leaflet. BRAN is short for the benefits, risks and alternatives of treatment, and the option of doing nothing. Thinking about these things ahead of your appointment with the surgeon will help you work together to decide what treatment option is best for you."
Peter: “Do I have to have an operation?”
GP: “Not necessarily. An operation is just one of your options. We'll support you to choose the best option for you. Give it some thought and consider what is most important to you."
Peter’s partner: “How are you feeling?”
Peter: “To be honest, I didn't realise I'd have a choice and I’m worried about making the wrong decision. I’ve been given a BRAN leaflet to help. It says at the clinic appointment I should think about the benefits and risks of surgery, the alternative treatment options, and what happens if I do nothing for now.”
Peter’s partner: “Why don't we write down some questions to take to your appointment?”
Peter: “That’s a good idea, otherwise I'd forget what I want to ask.”
Peter’s partner: “Have a think about what concerns you and what's most important to you.”
Peter: “But the most important thing’s our life together, seeing our grandkids grow up.”
Surgeon: “Hi Peter, it's nice to meet you. I can explain the different treatment options and we can make a decision together that's right for you."
Peter: “I've found my BRAN leaflet helpful and I've written down some questions I have.”
Surgeon: “Thanks for bringing some questions. Before we go further, I want to understand what really matters to you."
Peter: “The most important thing to me is to have as much time as I can with my family and to be able to look after myself."
Peter’s surgeon helps to compare the benefits and risks of the treatment options and discusses what happens if Peter decides not to have treatment at this point whilst also considering the questions Peter and his partner put together, Peter's concerns, and what Peter feels is most important to him and for his future.
Having discussed and explored all the options available to him Peter's able to be involved in the decision-making around the care and treatment that he receives, with the full support of his healthcare team so that he can be confident that it's the right path for him.
By using the tools available like the BRAN framework, it's never been easier for patients like Peter to be involved in making informed decisions to guide the care they receive.
Making the most of your appointment
Our leaflet called 'Making the most of your appointment' helps you to think about what matters to you. You can write down questions and think about how surgery might affect your life.
It's a good idea to bring the leaflet to your appointment. This helps to make sure you talk about everything that matters to you. You can then confidently choose what's right for you.
Taking more time to decide if you want surgery
If you need more time after your appointment to decide if you want to have surgery, please contact us.
You can tell us if you:
- want to be added to our waiting list
- have decided not to have surgery
- would like another appointment to talk about this in more detail
We send you a copy of the letter from your outpatient appointment a few weeks later.
If you choose to have surgery
If you choose to have surgery, we send you a letter explaining:
- the date and time to arrive
- how to prepare for the surgery
- if you will stay on a ward (be admitted as an inpatient) or have surgery and leave on the same day (day surgery)
- which hospital you need to go to
Pre-operative assessment to check your health
Sometimes, we need to do tests to check that you're well enough for surgery or confirm which surgery is right for you. This happens at our pre-assessment clinic.
You go to another pre-assessment clinic a few days before your surgery.
Read more about what to expect at the pre-operative assessment clinic.
If you are an older person with complex medical needs, then you might have an appointment with our POPS team to assess you before surgery instead of at the pre-operative assessment clinic.
Keeping well
Before you have surgery, it's important to look after your health and tell us if your condition changes.
Read more about keeping well while you wait.
Having the right information
Before your surgery, please read our information about:
Resource number: 5312/VER1
Last reviewed: August 2022
Next review due: August 2025
