To ask anyone in the NHS how day surgery lists are determined?

[ScuderiaSedici]

As above

😂👍🏼

No OP they won’t, I’m a GP. Nobody is going to laugh at this.

They certainly should take this into account and they may or may not be able to move things around to accommodate you as best they can, but at the very least if you let them know you’re this anxious about it they can let you know exactly where you are on the list and what sort of time you’re likely to be take for surgery, and keep you specifically well informed in good time if anything changes.

I can guarantee you that not everyone on a day surgery case list is worrying to this extent about exactly where they are on the list so honestly it’s not this much of an issue for the average person exactly what time their surgery is. I’d say for the majority of people they just want it done and the main worry would be about the surgery potentially being cancelled due to over-running on other cases.

That can of course feed in to some extent as to your position on the list, but for example when I recently had to have my gallbladder removed as a day case I couldn’t have cared less whether I was first, last, whatever, as long as it finally got done (it was cancelled twice before, once due to junior doctor strikes and the second time because of overrunning of another complex case). And when I had a carpal tunnel release as a day case I also couldn’t have cared less what slot I was in, it also wouldn’t have been the end of the world for me even if it was cancelled and rescheduled, though would have been a bit annoying as I had arranged work commitments around it etc. Though in that case I wasn’t fasting as I had that one under spinal block not general anaesthetic.

Do tell them how anxious the not knowing what to expect especially time-wise and potentially not being able to eat for a prolonged period is making you.

My ds ( 19) with autism & anxiety on his medical notes still had to wait 2 days. He didn't complain or get himself all worked up. I did wait with him the whole time as his mum. I still don't have any sympathy with the op. She's going to have to learn that the world doesn't revolve around her, autistic or not. Plus if she at some stage needs major surgery she will be grateful that she has a chance over relatively minor emergencies.

I think it would have been a right mess if I was an afternoon one as it was over 8hrs (I was meant to be a day case!)

I have to say before you posted that update I was thinking you were being pretty ridiculous and entitled about all of this and basically expecting a private service for NHS money. But I actually can understand now looking through the lens of the needs of a potentially autistic person quite how you might find the waiting and lack of control over the timing of it and not being able to eat etc meantime completely intolerable and particularly anxiety-making way more than for the average person. So it really matters if they have this extra information that you may have autism and are extremely anxious over it all, as they should try much harder to help you through this.

You’ve asked a question and people have answered it but the truth is nobody knows where in the list you will be. You’ve been rude and abrasive in your responses, said you’re going to walk out if you aren’t seen by 2pm and generally belittled/mocked the NHS and those who work for them. If you aren’t happy with the service you receive then go private. You will not be the only person on the list feeling anxious- it may do you well to remember that.

I can’t even put into words how the lack of insight into it has made me feel. I’ve had virtually no information (I only loosely know what type of procedure I’m having!), I’m bad enough when my routine is disrupted in other ways, let alone something like this that I’ve not experienced before. It’s this horrible sense of impending doom

I do have sympathy with the OP’s predicamemt. I’ve been in a similar situation: I need a routine hysteroscopy every year because of genetic cancer risk, and I insist on a GA. However I am healthy and have no symptoms so (rightly) am given no priority on the day. However, for 3 years out of the last 5, they have kept me waiting from 7am to between 5 and 7pm (and I was ostensibly on the morning list too!) I usually drink 2 or 3 litres of water every day, and have no colon, so by 3pm my body thinks it’s a famine! Last year, I very politely asked whether I could reschedule rather than wait longer, because I was dehydrated and brewing a migraine that might preclude me from looking after disabled DS. I also reminded them that I had been 20 hours without food or water. They let me have a sip or two of water and - as if by magic - I was called next. This year, I was seen within about 1 hour - in fact called before I’d managed to get the comedy stockings on!

Honestly, OP - they will want to help, but you catch more flies with honey than vinegar! If you’re struggling to wait, throw yourself on their mercy and be v polite doing so. OTOH I’ve had the same procedure privately with almost no waiting around, so that’s the option if you can’t/wont wait. It’s purely a numbers game.

You sound nasty, selfish, and idiotic to boot.
Can you honestly not imagine why someone sicker, more unstable or an emergency might trump your “simple operation”?

In my mind, no. Because day surgery unit = simple, day surgeries only. I have not had anything explained to me, i.e. are all surgeries taking place in the same theatres, is there a special theatre for day surgeries etc etc. the lack of control and insight is literally eating me up

You sound so childish, tbh, so maybe you will be first! Jesus Christ, the entitlement! Plenty of people have explained how priorities are decided according to the cases and the surgery team. Of course we would all want to be first, done and dusted, but be mature for a second.
When I had a planned c-section, I also had to get there at 6am, nil by mouth. And I didn't give birth until 2.40pm because they were more complicated planned c-sections and some emergency, unplanned ones. Was I starving, yeah, but I was so, so, so grateful that I was a straight forward, fairly uncomplicated case that went smoothly. I wouldn't have wanted to swap just to be first. Stop being ridiculous.

Latex allergy gets you at the top of the list in my local hospital.

And diabetes as already mentioned.

There are MANY reasons! You obviously have no clue!

it’s all me me me me me!

Well why don’t you ask the day surgery (in a polite and courteous way), rather than spiral on mumsnet.

Just remember that you’re lucky to have the NHS do this for free, none of the staff members are there to try and make your day difficult, and if you’re as rude as you have been on this thread you may be shown the door.

There are specific day surgery theatres, where different day surgery operations will happen. Yours is ENT so will be completed by an ENT doctor, there will be particular equipment needed and the theatre will be set up for ENT. There are some things that could be emergency or complex, more so than a 20-60 minute procedure.

With kindness most of the information you would like is irrelevant and of no interest to others. You will be on a list, you can eat and drink until midnight which could make tomorrow feel easier without being a glutton, the information about your wait will be given to you within a few hours of arrival. You will likely be sat in a chair in a room with curtains separating you from other people also on the list. When it’s your turn you will be collected and walk to theatre.

I hope you're trolling, it can't be real to be this stupid and horrible, frankly. Not hoping you wait all day starving then you get cancelled, but if it happens, I won't cry for you.

Even if you go private they still do the morning/afternoon sessions, you dont get a specific timeslot (or at least in the hospitals near me that I use). Because some people will test positive for MRSA/pregnancy etc, or operations be quicker than expected and the surgeon is able to move along to the next one quickly.

16 year olds are still paeds and have been under paeds for years but they’re adult sized

Someone has to do the waiting unfortunately. If you want to guarantee that you will go to theatre in the morning and not be kept waiting then you should go private where a surgeon will have fewer patients in their list!!

When I had surgery last December they had everyone in at 7am and I was last on the list; I didn’t go to theatre until after 3pm. By the time they got me out of theatre into recovery it was almost 9pm and then it was getting on for 10:30pm by the time I got up to the ward.

They did 5 surgeries before mine and it would have been unfair for the other 5 people to have to wait over 5 1/2 hours to start going down and mine was the most complicated case so I went in last. They did let me drink water until 1pm so I was well hydrated unlike previous times when I’d had nothing since the night before and was as dry as a bone by the time they tried to cannula the me in the anaesthetic room.

Oh and don’t expect to see your surgeon after the operation, you’ll wake up in recovery, be taken back to the ward, looked after by the dsu nursing staff and discharged by them. People are often surprised by that.

@ScuderiaSedici

I wonder if these people may be of help?

I do understand, especially because you really are giving up control over your body in a way you wouldn’t normally when you have surgery, especially if it’s under general anaesthetic. A lot of people do find that loss of control quite intimidating, especially if they are usually healthy and haven’t had much experience of this sort of thing before.

And yes they don’t tend to explain much in pre-op! Especially these days (prepandemic you’d often have been able to have a good chat with the surgeon about exactly what is proposed and why and all the ins and outs of it, but that seems to have generally gone out the window). Even I was surprised at how limited the information was beforehand, and I’d probably have found it a lot more daunting if I didn’t have insight as to how it all works from being a junior doctor.

And yes it’s going to be a total change in your usual routine whatever happens but I can see not knowing roughly when it might even happen is particularly challenging for someone with possible autism.

So please do tell them that you suspect you have autism but are usually healthy generally, and so you are finding the lack of control and change of routine and not knowing what to expect particularly anxiety-making and it would really help to know where you are on the list and if possible for your procedure to be done sooner rather than later. And then they can at the very least keep you posted as to what’s happening and whether anything looks like it might change through the morning if needed. I promise they won’t laugh at you or think you’re trying it on etc. Your level of anxiety over this is unusual and makes a lot more sense looking at it from the angle of possible autism.

You never know, you could end up first on the list so try not to panic now and overthink about worst case scenarios.

OP you sound really really stressed about this. The trouble is that all hospitals work slightly differently, and there are so many variables that I think you’re looking for answers no one here can give you. I can only suggest again that you talk to them (in advance, if possible) and explain the stress and anxiety this is causing you, because there might be things that can be done to help. If you have time before the day of the operation you could start with the consultant’s secretary and go from there.

Sip til send is being adopted widely across the nhs allowing patients to sip clear liquids until they are sent for. Makes the wait more bearable and I’m sure helps postoperatively.

No one can answer this as all hospitals have different set ups. Some day surgery units have their own separate theatres. Some hospitals (including the district general hospital that I work in) admit all elective patients via a day surgery unit then day cases and inpatients will be operated on on the same list- order to be decided by the surgeon. Often they do the daycases first as they will have spaces allocated to them on the day case unit rather than having patients sat in recovery all day waiting for a bed on a ward which doesn't become free until much later in the day when someone is discharged. It really just depends unfortunately.