Tavistock Hospital

Tavistock Hospital

Tavistock Hospital is a thriving community hospital, situated on Spring Hill Tavistock. The hospital has a busy Day Case Theatre Unit, which undertakes many different types of Day Case Surgery, under either a local or general anaesthetic.

Opening Times:

Monday to Friday, 7.30am to 6.30pm

Getting here

Tavistock Hospital, Spring Hill, Tavistock, PL19 8LD

Parking

There is a small car park which is free of charge.

Contact Us

Call 01752 436106 between 9am to 5pm

Tavistock Day Case Surgery

The following sections provide you with information on having a day case procedure at Tavistock Hospital Day Case unit. You can also find further information about your condition, including operation and discharge information, in the Your Operation section.

You will be admitted to hospital on the day of surgery and discharged home on the same day. You will need a relative, carer or friend to take you home after your procedure and to stay with you until you are self-caring.

Please call Tavistock Hospital on 01822 612233 between 9am and 5pm if there are any changes to your medical condition between your pre assessment and your surgery. 

We aim to provide you with an efficient, high-quality service for your day case procedure. This will allow you to go home on the same day as your surgery. As a day case you can participate in achieving the best result for you by doing the following:

  • Follow any pre-surgery health advice (e.g. stop smoking, lose weight, gentle exercise)

  • Follow the preoperative fasting advice

  • Remain active after discharge by moving your legs while in bed or walking regularly

  • Ensure your pain is well controlled

PDF Version:  Day case surgery Tavistock hospital.pdf [pdf] 305KB

Coming in for your operation

You will receive an admission letter from us advising you:

  • The date and time to come into hospital and where to go

  • About eating and drinking (pre-operation fasting)

You should:

  • Eat and drink normally up until the times specified on your admission letter

  • Have a shower or bath on the morning of surgery. This will reduce the risk of developing a wound infection

You should not:

  • Shave your operation site. Shaving increases the risk of developing a wound infection

  • Take the listed medicines on the morning of surgery (please print off the PDF version and fill out medicines)

Do take other pills / medicines

Consent

You will be asked to sign a consent form before your surgery to allow the surgeon to perform the required surgical procedure. The Anaesthetist will also talk to you and ask for your consent verbally to give the anaesthetic for your operation.

Please make sure that you understand the procedure, the risks and your options prior to signing the form. It is important that you completely understand the information and cooperate in your care. You will be given several opportunities to ask any questions you may have.

Please make sure you are given a copy of the consent form after you sign it.

An Outline of a Patient’s Journey

Seen by consultant, or member of their team

  • Decision made that surgery is needed and appropriate

  • Patient referred for review in the pre-op assessment clinic

Assessed by pre-operative assessment team

  • Patient’s fitness for surgery assessed

  • If fit, patient added to the surgery waiting list

Admission for surgery

Operation / Procedure

Post operative care

After discharge from hospital

Follow up may be needed with your GP, community nurses or with the specialist team in the hospital outpatient department.

Patients will be informed of arrangements before they leave hospital and their GP will know within 24 hours

Pre-operative Assessment

The Pre-operative Assessment appointment will last for approximately 1 hour. Please allow for this time when planning your day.

For some patients it may be appropriate to assess you over the telephone/video link. All others will need face to face appointment, clinical staff will make this decision on an individual basis.

At the assessment you will:

  • Be asked about your general health, medical history, medication and any allergies you may have

  • Have swabs taken to screen for MRSA (Methicillin Resistant Staphylococcus Aureus) if needed

  • Be given information about your operation

  • Be advised about when to start your pre-operation fasting (times to stop eating and drinking)

You may have investigations that will help the doctor assess any medical problems which may affect your anaesthetic or surgery. This can include a heart trace (ECG) and blood tests.

Your medication will be reviewed, and you will be advised which pills/medicines to take on the day of your operation and which ones not to take.

Please bring a list of all the pills, medicines, herbal remedies and supplements you are taking; both prescribed and those that you have bought over the counter.

Preparing Yourself for Surgery

If you smoke

Tavistock Hospital is a smoke free site. Giving up smoking for several weeks before the operation reduces the risk of infections. The longer you can give up beforehand, the better. If you cannot stop smoking completely, cutting down will help. You should try not to smoke on the day of your operation.

For support to quit smoking contact the Plymouth NHS Stop Smoking service on 01752 437177 or via email oneyou.plymouth@nhs.net  before you come into hospital.

Talk to your GP or nurse at pre-assessment clinic. They will be able to provide you with Nicotine Replacement Therapy (NRT) prior to your admission. All wards, including the preoperative admissions ward, can provide you with NRT to help with cravings if you should need it 
on the day of surgery.

If you are overweight

Reducing your weight will reduce the risk of developing a wound infection after surgery.

Long standing medical conditions

If you have a long-standing medical condition such as diabetes, asthma or high blood pressure (hypertension) you should make sure they are well controlled. See your GP if you have any concerns.

Dental problems

If you have loose teeth or crowns, treatment from a dentist may reduce the risk of damage to your teeth during anaesthesia.

Postoperative wound infection

  • Ensure you are thoroughly showered before surgery.

  • Good hand and personal hygiene reduces the risk of wound infection.

What to Bring With You

As storage space is limited, only bring essential items with you. You are having a day case procedure, so you do not need an overnight bag.

Essential items to bring with you:

  • A warm dressing gown

  • Indoor footwear e.g. slippers

  • Book or magazine

  • Your pills and medicines (in the original containers)

  • A small amount of money

  • Any booklets/letters that the clinical team ask you to bring

Please do not bring:

  • Cigarettes or tobacco

  • Alcoholic drinks

  • Large sums of money

  • Valuables such as jewellery

  • Mains electrical equipment

Prior to theatre, ensure that:

  • Body piercings and nail varnish are removed

  • Excess make-up is removed

  • Jewellery is removed, wedding band can be taped

Please be aware that any valuables including money, jewellery and expensive electronic equipment are brought in at your own risk and the hospital is not liable should they go missing or become damaged.

Eating and Drinking Before Your Operation: Fasting Instructions

Before your operation you should eat and drink normally until the times written in the fasting instructions below:

You are coming in between 7am and 10:30am

  • Have a late night snack. You can eat until 2:30am

  • Have a drink of water until 6:30am

You are coming in at 1pm

  • You can have a light breakfast before 7am

  • Have a drink of water until 11am

Then, you may drink half a cup (100ml) per hour until you go to theatre. There is a water dispenser available on the ward.

Do not have chewing gum or sweets/mints between the time you should stop eating and your operation.

Patients with Diabetes

As you are a day case, we expect you to be eating and drinking soon after your operation. You should be placed first or second on the list to keep your ‘fasting time’ to a minimum. We aim for all patients on insulin to be seen at pre assessment by a diabetes specialist nurse.

Refer to the diabetes leaflet regarding guidance for taking medication on the day of surgery. If you have any queries, contact 01752 7430388

Day of Admission

Check in

  • Our receptionist will check your details.

  • Patients who are first on the theatre list will be admitted first.

Meet and greet

  • A nurse will outline the layout of the ward and check your discharge details.

  • You will have a wristband attached showing your identity.

Medical review

This will consist of:

  • A review of your medical details: tests, scans and previous information will be checked.

  • Anaesthetists assessment: to establish you are fir for an anaesthetic.

  • Medical preparation for surgery: your weight, heart rate and blood pressure will be recorded. Additional blood tests may be necessary.

  • Surgeon’s assessment and consent: this will involve a physical examination, any additional tests may also be identified.

Final check

  • Patients will change into a theatre gown and surgical stockings if required.

  • Nursing staff will complete final checks and secure all personal items.

Transfer to theatre

Timings are based on a theatre schedule. Delays can occur if a case takes longer than expected.

The Admission Ward

When you come into hospital for your operation you will wait in main reception, until you are called to the unit. At this point, we will check details of who is collecting you and then they are free to leave until we call them with your discharge time.

Your admission letter will advise which area to go to on arrival to the hospital.

On the admission unit you will see a nurse who:

  • Will show you to your bed space.

  • Will confirm your details and attach an identity bracelet.

  • May measure your legs for a pair of surgical stockings (TEDs) to prevent blood clot formation.

  • May give you some tablets/medicine.

Your Anaesthetist, who:

  • Will confirm your personal and operation details.

  • Will ask about your general health.

  • Will discuss the types of anaesthetic/pain relief available.

  • May allow you to have a drink, depending on the time of your operation.

Your Surgeon, who:

  • Will confirm your personal and operation details.

  • Will confirm/gain your consent for the operation (you will be given a copy).

  • Will mark the site of your operation with a marker pen.

Nothing will happen to you until you understand and agree with what has been planned for you. You have the right to refuse if you do not want the treatment suggested.

Going to theatre

Most patients walk to the theatre. You will be taken by a member of staff.

You can wear your glasses, hearing aids and dentures until you are in the anaesthetic room. If you are having a local or regional anaesthetic, you may keep them on.

Theatre staff will check your identification bracelet, your name and date of birth and will ask you about other details in your medical records, as a final check that you are having the right operation.

Routine monitoring equipment to record heart rate and blood pressure will be attached to you. This will involve placing sticky discs on your chest underneath your surgical gown.

As part of the Surgical Safety Checklist there will be a final check of your details before you are given your anaesthetic and you have your operation.

The Recovery Area

After your operation you will be transferred to the recovery room. This is where all patients go for a period of close observation after surgery.

When you are sufficiently recovered you will go from first stage to second stage recovery, where you can have a drink and a biscuit.

Once you are safe to go home the nurse will complete the discharge checklist and provide you with discharge information. Your relative/friend will need to sign to say they have received and understood this information.

A Guide to Anaesthetics

Anaesthetists are doctors who:

  • Are responsible for giving you your anaesthetic and for your wellbeing and safety throughout your surgery.

  • Discuss types of anaesthesia and the associated risks with you.

Some types of anaesthesia

Anaesthesia stops you feeling pain and other sensations. It can be given in various ways and does not always make you unconscious.

  • Local anaesthesia (LA) involves injections which numb a small part of your body. You stay conscious but free from pain.

  • Regional anaesthesia (RA) involves injections which numb a larger or deeper part of the body. You stay conscious but free from pain.

  • General anaesthesia (GA) gives a state of controlled unconsciousness. It is essential for some operations. You are unconscious and feel nothing.

Combinations of anaesthetics are often used e.g. GA plus LA.

Anaesthetic risk

People vary in how they interpret words and numbers. This scale is provided to help you understand definitions of risk.

Anaesthetic risk
Risk Very Common Common Uncommon Rare Very Rare
Number 1 in 10 1 in 100 1 in 1000 1 in 10,000 1 in 100,000

 

Side Effects and Complications

RA = This may occur with a regional or local anaesthetic

GA =This may occur with a general anaesthetic

Very common and common side effects (1 in 10 - 100)

RA GA Feeling sick and vomiting after surgery

GA Sore throat

RA GA Dizziness, blurred vision

RA GA Headache

RA GA Itching

RA GA Aches, pains and backache

RA GA Pain during injection of drugs

RA GA Bruising and soreness

GA Temporary confusion or memory loss

Uncommon side effects and complications (1 in 1000)

GA Chest infection

RA GA Bladder problems

GA Muscle pains

RA GA Slow breathing (depressed respiration)

GA Damage to teeth, lips or tongue

RA GA An existing medical condition getting worse

GA Awareness (becoming conscious during your operation)

Rare or very rare complications (1 in 10,000 - 100,000)

GA Damage to the eyes

RA GA Serious allergy to drugs

RA GA Nerve damage

RA GA Equipment failure

Deaths caused by anaesthesia are very rare and are usually caused by a combination of 4 or 5 complications together.

There are probably about five deaths for every million anaesthetics in the UK.

 

You can get further information about Anaesthesia from:

The Association of Anaesthetists of Great Britain and Ireland (AAGBI)

Royal College of Anaesthetists

Pain Relief

It is common to feel some pain after an operation. Different operations lead to varying degrees of discomfort and everyone experiences pain differently. We will make sure you are comfortable and that any pain is at an acceptable level before you go home.

Pain relief is available in different forms and strengths. The type of pain relief will be discussed with you by your anaesthetist and will depend on the extent of surgery, your general health and personal preferences.

Types of pain relief:

Oral medication

Tablets or liquid painkillers like paracetamol and ibuprofen are suitable for mild to moderate pain. Make sure you take these at home. They are most effective when taken regularly. These tablets are generally safe. Codeine containing tablets can make you drowsy, nauseated and cause constipation. Anti-inflammatory tablets like ibuprofen can cause gastric irritation and are best taken with food.

Local Anaesthetic Infiltration

This is done by the surgeon around the operative site at the end of the operation. It numbs the incision site and helps with pain relief in the first few hours after surgery.

Regional anaesthesia-A Nerve Block

For operations on the arm or leg, an injection of local anaesthetic can be given near the nerve. This will numb the particular area for several hours after the operation (2 to 24hours).

You may either receive a single injection at the start of the operation or alternatively your anaesthetist may leave a catheter (fine tube) near the nerve so that the local anaesthetic can be continued to be administered for up to 2 days after the operation. The anaesthetist will discuss this with you in more detail.

You may not be able to control the movement in the arm or leg and the feeling of numbness and heaviness will only go away when the LA wears off.

Regional anaesthesia: Spinal

This is an injection close to your spinal cord and numbs you from the waist down. It can be given with or without GA or sedation. Although there is no feeling at operative site while the spinal works, you may experience pain when the spinal wears off. Therefore it is important to get painkillers on board.

Advice Following General Anaesthesia

Minor side effects are common. These include:

  • Headache, dizziness, light-headedness.

  • Nausea and/or vomiting.

  • Sore throat and dry mouth.

  • Tiredness, aches and pains.

For your safety, we advise that in the first 24 hours after surgery you do not :

  • Drive (please contact your own insurance company.

  • Regarding your policy and general anaesthetic).

  • Work, operate machinery, use electrical equipment or tools.

  • Drink alcohol.

  • Sign legal documents i.e. cheques.

You must have a responsible adult with you until you are completely self-caring. This is usually 24 hours but can be longer depending on your circumstances. The responsible adult needs to be aware of :

  • Risk of bleeding-slight oozing is normal but call ambulance if there is a large amount of blood loss or if the patient becomes dizzy/disorientated which could indicate internal bleeding.

  • Uncontrollable pain, if prescribed medicine is not helping, call the GP or call an ambulance.

  • If sickness or vomiting does not ease after 24hours, get advice from a GP, call NHS direct or call an ambulance.

Help After Your Operation

Who to contact if you have concerns about your treatment.

In the first 48 hours after surgery

Monday to Friday, 8am to 6pm ring the hospital area you were discharged from:

  • Tavistock Hospital Tel: 01822 612233 (8am to 5pm)

  • Postbridge Ward Tel: 01752 431225

After 8pm and at weekends contact 111

48 hours after surgery

Contact your GP or practice nurse.

In an emergency

Ring 999 for an ambulance and return to hospital.

The First Few Days at Home

Wound Care

Slight redness and tenderness is normal for the first 1-2 weeks.

If you experience any of the following please follow the contact advice on the Help After Your Operation section:

  • Excessive bleeding/fluid discharge from the wound.

  • Inflammation.

  • Pain.

  • Swelling.

Removal of Clips/Stitches

  • Some stitches dissolve over a period of time and will NOT need to be removed.

  • Other stitches and clips will need to be removed. This is usually done between 10 to 14 days after surgery by the Practice Nurse at your GP surgery or Tavistock Dressing clinic.

Exercise

Gradually increase your activity during the weeks following your operation until you are back to your normal level of activity.

Work/Returning to normal activity

Your surgeon will advise you when you can return to work/normal activity following your operation. If required, you will be given a fit/sick note.

Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)

DVT is the term used when a blood clot develops in the deep veins in the leg, most frequently below the knee. A PE is when a part of a DVT breaks off and travels to your lung. This is a potentially serious complication.

At your pre-assessment visit your risk of DVT will be assessed and your treatment, if any, may include:

  • Surgical stockings fitted prior to going to theatre, keep these on until you are moving around to your normal level of activity

  • Blood thinning drugs in the form of injections or tablets, you may need to take them after your operation

Moving your legs while in bed and walking as soon as possible after surgery will help reduce the risk of clots forming.

Hospital admission can increase your risk of developing a blood clot. This risk remains for several weeks after discharge, so it is important to keep active and drink plenty of fluids to avoid dehydration.

A DVT can cause pain, selling, tenderness or discolouration of the legs. PE can cause breathing difficulties, chest pain or coughing up blood. It is very important to seek urgent medical help if these problems occur.

General information

Mobile Phones

Areas where mobile phones can be used will be signed in the hospital. There are areas in the hospital where mobile phones cannot be used because they interfere with sensitive equipment. Please show respect to other patients by using your phone quietly. Please do not take any photos.

WiFi

WiFi is available free of charge and be accessed by connecting to NHS Wi-Fi network and registering.

Car Parking

Car parking is free of charge but there is limited space.

We ask relatives/friends to remove the car from the car park, once you are admitted to allow patients to attend their appointment.

Patient Advice and Liaison Service

The Patient Advice and Liaison Service (PALS) offers help, advice and support to patients, relatives and visitors. They can:

  • Help with problems that you haven’t been able to sort out with staff on a ward.

  • Advise you how to make a complaint.

  • Tell you about independent organisations that can help you make a complaint.

  • Listen to your views on how we can improve our services, and pass this on to the appropriate people for action.

PALS are open Monday to Friday from 9am to 4.30pm

Patient Advice and Liaison Service

Patient Services Office, Level 7, Derriford Hospital, Plymouth PL6 8DH

Telephone: 01752 439884

Email: plh-tr.PALS@nhs.net

Transport Access People (TAP)

Provides a safe co- ordinated cost-effective transport service for the community. The service is for people who need help with any non- urgent health related journey, whether you wish to travel alone or with a friend TAP will help with all your needs.

TAP brings together many of the voluntary transport providers, under one telephone number. 

A small charge will be made.

Cornwall Patients

01872 252211

Monday to Friday 8am to 7pm

Plymouth and Devon Patients

0345 155 1009

Monday to Friday 7am to 6pm

Your Operation

Section content

Select from the list of specialities to find out more about your condition including operation and discharge information.

 

Colorectal

Anal fistula Treatment

Anal surgery discharge information

 

Haemorrhoidectomy Patient Information Leaflet

Haemorridectomy discharge information

 

Hernia information

Hernia repair discharge information

 

Pilonidal sinus

Pilonidal sinus discharge information

Back to section content

Urology

Testicle and scrotum problems

Small scrotal surgery discharge information

 

Vasectomy information

Vasectomy discharge information

 

Cystoscopy procedure information

Cystoscopy discharge information

 

Circumcision in men

Circumcision discharge information

Back to section content

 

Ear Nose and Throat (ENT)

Mastoid Surgery / Cholesteatoma

Major Ear Surgery discharge information

 

Tonsillectomy (taking out your tonsils) because of repeated infections

Tonsillectomy discharge information

 

Hole in the Eardrum and Myringoplasty

Myringoplasty discharge information

 

Grommets post operation information

Back to section content 

Hepato-Pancreato-Biliary (HPB)

Hernia information

Hernia repair discharge information

Back to section content

 

Plastic Surgery

Carpal tunnel syndrome

Discharge information Carpal tunnel

 

Dupuytren's contracture

Dupuytren’s contracture discharge information

 

Surgery for small skin cancers

Plastic surgery discharge information 

Back to section content

Gynaecology

Information For Patients Having a Gynaecological Laparoscopy

What happens during female sterilisation

Endometriosis information

Back to section content

Anaesthetics

General anaesthesia

Back to section content

Pain

Pain after surgery information leaflet

Back to section content

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