Guidance to support the separation and streamlining of preoperative assessments (POAs) for patients who are having a local anaesthetic (LA) for their procedure is now available from the Getting It Right First Time (GIRFT) team. 

Through the GIRFT POA network, the programme has heard evidence of patients undergoing LA procedures (minor surgery and operations) often being assessed in the same POA clinics as those requiring general or regional anaesthesia. 

This can not only delay access for patients needing more detailed preoperative assessments, pushing back their ‘to come in’ (TCI) dates, but can also result in unnecessary testing for LA patients, given that attending POA clinic puts them in an environment where additional testing is common due to the risks associated with general anaesthesia. 

The new GIRFT guidance describes a best practice approach already in use at a number of NHS providers, which rationalises the assessment process for LA patients only and can be delivered by a wide range of staff. 

Among the key principles it outlines are: 

• There should be a separate, streamlined process for preoperative assessment of patients undergoing procedures using local anaesthetic only. 

• In this process, each patient should be assessed using a standard screening questionnaire relevant to the procedure and the essential information required by the operator.  

• This screening can take place when patients are listed for surgery, either in their outpatient appointment or remotely afterwards.