Overview

If you're considering having an operation or your GP has suggested you may need surgery, this guide is for you.

It will take you through all the steps in the process, from referral to recovery, so you're fully prepared and know what questions to ask at each stage.

Before you start, you'll need to decide which hospital you'd like to be referred to. Our tips on choosing a hospital can help. You can also compare hospitals by following these steps:



search for hospitals by surgical procedure



enter your postcode and the name of your operation



you'll be taken to a page listing the hospitals that can carry out the operation



using the columns and drop-down menu, you can compare hospitals based on things such as performance, safety, complaints and facilities



Once you've chosen your hospital, your GP will refer you to see a specialist at this hospital.

You can find out more about each stage of the treatment journey by using the links below:



Seeing a specialist– an initial consultation to discuss your treatment options and agree what's right for you.



Preparing for surgery– what to do in the days leading up to surgery, and your pre-operative assessment.



Day of the operation– arriving at hospital, information for visitors, and what happens before you go into theatre.



After surgery– coming round from the operation and being discharged from hospital.



Getting back to normal – general advice and typical recovery times.



Meeting with a specialist 

Your first appointment will be with a consultant or another member of the surgical team. You can bring someone with you to this appointment.

At this stage, it's not guaranteed that surgery will be right for you. Only the consultant can make this decision, after carrying out tests, making a careful assessment and weighing up all the treatment optionsavailable to you.

You may want to ask your specialist the following questions:



What are the different types of treatment for my condition?



What are the benefits, side effects and risks of each of these treatments?



Why are you recommending I have this operation?



Are other types of non-surgical treatment possible for my condition?



If an operation is necessary, this will be your chance to find out what the operation involves, why it's needed, and whether it's suitable for you. Below are some questions you may want to ask:



Who will perform the operation? What qualifications and experience do they have? 



What exactly does the operation involve, and how long will it take?



What type of anaesthetic will I need?



How long is the waiting list for this operation?



How will I know if the operation is a success?



Don't be afraid to ask practical questions, such as:



Will I need stitches and will there be scarring?



How long before the operation will I need to stop eating and drinking?



How long will I need to stay in hospital?



How long will it take me to recover and get back to normal?



Will I need time off work and, if so, for how long?



Make sure you discuss any concerns with the consultant.

You may wish to ask if there's any written information about the operation or procedure you can take away with you.

The Royal College of Surgeons of England (RCS) website has the answers to more questions about surgery.

At the end of the session, your consultant may book your operation or ask you to come back for a further appointment. They may take your informed consent at this stage, which indicates that you know what the surgery is for and that you understand the risks and benefits.

Once booked, you should receive a letter with details of your operation, asking you to confirm you're happy with the proposed date and time.

What happens next?

See preparing for surgery for information and advice on getting ready for your operation.

Preparing for surgery 

In the days leading up to your surgery, you'll need to make travel arrangements for getting to and from the hospital, and think about what to pack.

Make sure you give your family and friends plenty of notice about your operation, so they can take time off work to be with you, if necessary.

Check your hospital's policy on visiting times and let your family and friends know.

Pre-operative assessment

At some hospitals, you'll be asked to attend a pre-operative assessment, which may be an appointment with a nurse or doctor, a telephone assessment or an email assessment. You'll be asked questions about your health, your medical history and your home circumstances.

If the assessment involves a visit to the hospital, some tests may be carried out, including MRSA screening and blood tests.

This assessment will usually happen one or more days before your operation.

Make sure you know the results of any previous tests, as well as all the medications, vitamins and herbal supplements you take. 

You'll be given clear information on:



whether you need to stop eating and drinking in the hours before your operation (see below)



whether you should stop taking your usual medications before going into hospital



what to bring with you into hospital



whether you'll need to stay in hospital overnight and, if so, for how long



Importance of fasting

If your doctor has instructed you to fast before the operation, it's really important that you don't eat or drink anything – this includes light snacks, sweets and water. You need an empty stomach during surgery, so you don’t vomit while you're under anaesthetic.

If you take insulin because of diabetes you'll still need to avoid eating and drinking before surgery, but make sure your medical team is aware of your condition, so appropriate precautions can be taken.

Hygiene

You'll need to remove all body piercings, make-up and nail polish before your operation. This can help to reduce unwanted bacteria being brought into the hospital. Also, the doctors will need to see your skin and nails to make sure your blood circulation is healthy.

What to pack for hospital

If you're staying in hospital, you may wish to pack:



a nightdress or pyjamas



day clothes



reading glasses



clean underwear



dressing gown and slippers



small hand towel



toiletries – soap, toothbrush, toothpaste, shampoo, deodorant



sanitary towels or tampons



razor and shaving materials



comb or hairbrush



book or magazines



small amount of money



medication you normally take, and a list of the doses for each medicine



notebook and pen



healthy snacks



address book and important phone numbers, including your GP's contact details



Different hospitals tend to have different rules concerning personal electronic equipment. You may want to check with your hospital about their policy on the use of mobile phones, MP3 players and laptops/tablets during your hospital stay.

Remember to bring your appointment card or admission letter with you too.

Getting to and from hospital

Think about how you'll get to the hospital and back again. You probably won't be well enough to drive, so you may want to arrange transport or ask a friend or relative to help. In some cases, the hospital may be able to arrange transport home for you.

Some hospitals will charge for parking. You may be able to check whether you have to pay for parking at your chosen hospital by finding your hospital and selecting "facilities".

Cancelling and rearranging

If you're unable to attend your hospital appointment or you don't feel well enough to have your operation, let the hospital know as soon as possible. Your admission will be rearranged for another day.

Let your surgeon know if you develop a cough, cold or fever a few days before surgery. They'll advise whether your operation can go ahead.

Preparing your child for surgery

Watch a video about your child's hospital stay to find out how you can prepare your child for a stay in hospital, what to bring, and the facilities available for parents and children.


The day of the operation 

Your admission letter from the hospital will tell you the date and time of your operation, and what time you need to arrive.

It should also tell you which ward or department you're going to be in, a contact number for your hospital or ward, and the consultant who will be taking care of you.

When you arrive, you'll be welcomed by a member of staff, who will explain the processes to you and give you an identity bracelet to wear during your stay in hospital.

During your time in hospital, you may be asked the same questions by several people. This is routine, and ensures that correct information about you is checked and available at each stage of treatment.

You may want to ask some questions of your own, such as:



What happens before the operation?



Why do I have to wear the surgical stockings?



Can I still eat and drink before the operation?



What will I feel like after the operation?



How long will the effects of the anaesthetic last?



Will I feel any pain after the operation?



How will my pain be managed after the surgery?



What should I do and who should I tell if I'm in pain?



What are the visiting arrangements?



Will I return to the same ward after the surgery?



When will I see the consultant?



When can I expect to go home after the operation?



When will I be told of any results of samples taken?



Medication

Take any medicines your doctor asked you to take before surgery. However, if you normally take tablets or insulin for diabetes, make sure you discuss this with your specialist as soon as possible before your operation.

You'll be asked whether you're allergic to any medication or whether any relatives have ever had any problems with an anaesthetic, so suitable precautions can be taken.

Company and visitors

Family or friends can usually stay with you until you leave for the operating theatre, at which point they can wait for you in the waiting room.

Just before the operation

You’ll be asked to change into a hospital gown, and the details of the operation will be explained. You'll then be asked to sign a consentform, giving your permission for surgery to go ahead. This form indicates that you know what the surgery is for, and you understand the risks, benefits and alternative treatments.

For some operations, a needle connected to a drip will be injected into your hand, allowing fluids, nourishment and medicine to be given while you're under anaesthetic.

Anaesthesia

You'll be given an anaesthetic, so you won’t feel any pain during the operation.

A general anaesthetic will be needed for a major operation, which means you'll be asleep throughout the whole operation. It will be given to you via an injection or gas, which you breathe through a mask.

There's no need to be anxious about having a general anaesthetic: the anaesthetist will be by your side the whole time you are asleep, carefully monitoring you, and will be there when you wake up.

If you don't need to be put to sleep, you'll be given a regional anaesthetic. This means you’ll be conscious throughout, but you won't feel any pain. It may be a local anaesthetic, where a small area is numbed, or an epidural, which reduces sensation in the upper or lower areas of your body.

Watch a video about anaesthesia for more information.

What happens after surgery 

After surgery you’ll be moved to the recovery room, where you’ll be told how the operation went.

You may feel hazy or groggy as you come round from the anaesthetic. A nurse will give you oxygen (through tubes or a mask) to help you feel better.

It's common to feel sick or vomit after you've been given anaesthesia. Your nurse may offer you medicine to help relieve this discomfort. You may also have a sore throat and dry mouth.

Your blood pressure will be taken via an automatic cuff that squeezes tightly at regular times. Your temperature will also be taken.

The outcome of your operation

It's important to find out how well your operation went. Here are some questions you may want to ask:



Was the operation as successful as expected?



What effect has the operation had on my condition?



How will I expect to feel when I get home?



How long will it be before I'm back to normal?



Managing pain

Tell your nurse as soon as you start to feel any pain, so they can give you painkilling medication as soon as possible, to stop it getting worse (the medication can take 20 minutes to start working).

Avoiding blood clots

The sooner you start to move around, the better. Lying in bed for too long can cause some of your blood to pool in your legs. This puts you at risk of a blood clot.

If possible, doing some leg exercises can help to prevent a blood clot. These may be as simple as flexing your knee or ankle and rotating your foot.

You may be given special support stockings to wear after surgery to help your blood circulation. Your nurse or doctor will explain how you should use these. Some people are given an injection to thin the blood slightly to help reduce the risk of clots.

Enhanced recovery

Research shows the earlier you get out of bed and start walking, eating and drinking after your operation, the better.

Your hospital may offer an enhanced recovery programme if you've had major surgery. This rehabilitation programme aims to get you back to full health quickly, which means you could go home sooner than traditionally expected.

Plan for your days following surgery

It's important to arrange for appropriate care following your operation. For elderly people, it's important to arrange for suitable equipment and care. You shouldn't be afraid to ask for things that may help you, such as a wheelchair or walking frame.

Discharge

Before you leave hospital you may (depending on the type of operation you had) have an appointment with a physiotherapist, who will be able to advise you about any exercises you need to carry out.

You'll also be given advice about how to care for your wound, a dose of painkillers, and any equipment you may require, such as dressings, bandages, crutches and splints.

Each hospital will have its own policy and arrangements for discharging patients. Your discharge will be affected by:



how quickly your health improves while you're in hospital



what support you'll need after you return home



You may want to ask some questions before you leave hospital, such as:



Who should I call if I have any concerns once I'm home?



What should I be trying to do on my own – for example, going to the bathroom and getting out of bed?



Is there anything I should avoid doing?



When can I go back to work?



How much pain, bruising or swelling should I expect when I get home?



When and where will any stitches be removed?



Do I need to return to hospital or my GP for follow-up? If so, when will this be?



Transport home

You won’t be able to drive yourself home after surgery. Instead, you could ask someone to pick you up or take you home in a taxi. It's a good idea to have an adult available to help you for at least 24 hours after surgery.

What happens next?

See the page on getting back to normal for information and advice on recovering from an operation at home.