Before your stay

It is important that you follow any instructions which have been given as part of preparation for an operation or procedure (provided at your consultation, pre-operative assessment or written information sent with patient letters).

Confirming your surgery date

The date that you have been given for surgery is the earliest date that your surgeon is able to offer you. You need to contact the number printed on your admission letter as soon as possible to let us know if this date is not suitable.     

On the day of your admission

If you require assistance (e.g. wheelchair) you can contact the porters on the phone located opposite the Courtyard Garden.

If your surgery is not taking place on the same day as your admission, you can eat and drink normal. Try to drink 8-10 glasses of water per day in the weeks before and after your surgery. This will help your wound to heal well, make you less tired and help you to recover more quickly. If you are normally on a restricted fluid intake, please consult medical staff before changing your fluid intake.

Once you are admitted you will be seen by members of the team prior to surgery.

Visiting

Once you are back on the ward, visitors are welcomed between 1pm-5pm and 6pm-8pm. Visitors should not enter the hospital if they have symptoms of cold, flu, COVID, or any other respiratory infection. 

Visiting is limited to 2 people at anyone time. 

Protected meal times

We ask visitors to avoid meal times from 12pm - 1pm and 5pm - 6pm, however relatives, carers and visitors can play a vital role in assisting hydration and nutrition. If you would like a visitior to assist you during a meal time, please discuss this with the ward manager or nurse in charge. 

What to bring with you

• Your usual medication in labelled boxes.
• Wash bag with small toiletries-soap, shower gel, toothbrush and paste,  shaving items, etc.
• Glasses/contact lenses/hearing aid/ dentures and denture pot.
• Set of modest nightwear (long night shirt/pyjamas and dressing gown).
• Set of loose fitting, comfortable day wear (avoid zips and tight fitting clothes).
• Underwear.
• Slippers/indoor shoes (preferably not backless or flip-flop style).
• Book, magazine, pen, puzzle book.
• Small amount of cash.
• Headphones to use the free Digital Patient Information and Entertainment system. You can use the system for free during your stay to watch entertainment services. The system also provides digital access to our Patient Information Leaflets, physiotherapy and recovery educational videos and updates on hospital news.

Storage space is very limited, your luggage will be kept in a lockable locker measuring length 60cm x width 40cm x height 30cm. Please leave valuable items such as jewellery, large amounts of cash and electrical items at home. 

Infection prevention and control  

Infection prevention and control is a high priority. Our infection control team are there to help but there are some things you can do yourself to reduce the risk of infection and enhance the recovery process:

• In order to reduce the risk of infection and give you the best possible outcome we would ask that you take a hot soapy bath or shower on the night before surgery and the morning of surgery, including washing your hair. Do not use deodorant spray, body lotion or perfume.
• Wear a full set of clean clothes on admission
• Clip your nails and remove any nail polish
• Do not shave the area of the surgery
• While in hospital, keep your bed space as clear as possible
• You are encouraged to ask any member of staff to clean their hands before touching you 
• Always wear slippers or light shoes
• Inform the nurse if your dressing is wet or loose
• Never share your toiletries
• Tell your visitors that no flowers are allowed on the ward 

Medication information

You will be given a green medication bag at your pre-operative assessment appointment to put all your medication in. On admission, please bring in all the medication that you take, including Tablets, liquids, capsules, creams, eye drops, inhalers, patches, sprays, injections, and any other medication you may have bought from a chemist, supermarket or health food store. If you have any tablet  organiser boxes (dosette), please also bring these in. If you have a repeat prescription request slip normally attached to the green NHS prescription from your GP, please also bring this with you. Wherever possible please ensure that all medication is in its original box with a label attached to it that explains how your correct medication is prescribed for you during your hospital stay.

How will I take my medication?

When you come into hospital, your medication will be stored in a medication  locker next to your bed. Your medication will be reviewed by the doctor and a pharmacist. The nurse will give them to you as prescribed or you may be able to give them to yourself as you would at home. If you choose to do this, you will be given a key to your medication responsibility for this. Before you are able to participate in this  self-administration scheme, you will be required to discuss with your nurse and pharmacist exactly what self administration involves and what the possible benefits are. For safety reasons, identified criteria must be met and there are certain times during your stay that it is not appropriate to be self-administering your medication, e.g. following recovery from a general anaesthetic. Self-Administration is not compulsory and you must not feel that you have to take part even if asked. If you are asked and agree to take part, then before starting a trained member of the nursing staff or the ward pharmacist will explain:

• The self-administration process
• Which medicines you will be taking
• Dosages
• Possible side effects

What happens if my medication runs out or changes?

If your medication runs out, a further supply will be dispensed from our pharmacy department. If the dosage of any medication has changed then the pharmacy team will supply a new pack or re-label your own pack with new instructions on how to take or use your medication. If any medication has been stopped, then these will be removed and destroyed by pharmacy, where consent has been given. If you are not happy for the removal and destruction of any stopped medication then we would ask you to make arrangements for these to be sent home with relatives or friends. These should not be used during your stay as any deviation from what is prescribed by the hospital doctors can be potentially harmful to your health.

Blood clots

What are hospital-associated blood clots?

A hospital-associated blood clot occurs in patients when they are in hospital, and up to ninety days after a hospital admission.

There are two kinds:

Deep vein thrombosis (DVT): a DVT is a blood clot (also known as a thrombosis) that forms in a deep vein, most commonly in your leg or pelvis. It may cause no symptoms at all or cause swelling, redness and pain.

Pulmonary embolism (PE): If a clot becomes dislodged and passes through your blood vessels it can reach your lungs, this is called a PE. Symptoms include coughing (with blood stained phlegm), chest pain and breathlessness. If left untreated a PE can lead to death.

Health professionals use the term venous thromboembolism (VTE), to cover both DVT and PE. If you develop any of these symptoms either in hospital or after your go home, please get medical advice immediately.

Are blood clots common?

Blood clots occur in the general population in about one in 1000 people every year. You may have heard about DVT in people who have been on an aeroplane, but you are much more likely to get a blood clot after  going into hospital. In fact, about two thirds of all blood clots occur during or after a stay in hospital. Each patients risk is assessed on admission to hospital. If you are at risk, your doctor or nurse will talk with you about what will be done to offer you protection against clots.

Who is at risk?

Any unwell adult admitted to hospital is at risk. Other examples of factors that put people at greater risk include:

• having an operation
• a previous clot
• a recent diagnosis of cancer
• certain ‘sticky blood’ conditions such as antiphospholipid syndrome or Factor V Leiden
• being overweight
• being immobile
• oestrogen-containing contraceptives and hormone replacement
• significant injury or trauma during and after pregnancy

What can be done to reduce my risk?

Inflatable sleeves: you may be asked to wear calf or foot pumps; special inflatable sleeves around your legs or feet while you are in bed or sat still in a chair. These will  inflate automatically and provide pressure at regular intervals, increasing blood flow out of your legs.

Stockings: in hospital, you might be measured and fitted with anti-embolism stockings for your legs. You should be shown how to wear them and told to report any new pain or discomfort in your feet or legs. Your stockings will be removed for a short time every day so that you can have a wash and check for any skin problems.

Blood thinners: most patients at risk will be prescribed a small dose of an anticoagulant (blood thinner). These reduce the chance of having a blood clot by thinning your blood slightly. If you need to take these medicines when you leave hospital, you will be told how long to take them for. The blood thinner most often used is a type of heparin, which is given by injection. Please be aware that some ‘blood thinners’ are derived from animal origins. Please discuss with your nurse or doctor if this is a concern to you.

There may be reasons why some of the above are not suitable for you. To be effective, these methods of prevention must be used correctly and the course prescribed completed. If you have any questions or concerns, please ask your doctor or nurse.

What can I do to help myself?

If possible, before coming into hospital:

• Keep a healthy weight
• Talk to your doctor about contraceptive or hormone replacement therapy. Your doctor may consider stopping them in the weeks before an operation and will provide advice
• on temporary use of  other methods if your usual contraceptive is stopped.
• Do regular exercise

When in hospital:

• Keep moving or walking and get out of bed as soon as you are able after an operation – ask your nurse or physiotherapist for more information
• Ask your doctor or nurse: “what is being done to reduce my risk of clots?”
• Drink plenty of fluid to keep hydrated. 

What happens when I go home?

Until you return to your usual level of activity, you may need to wear anti-embolism stockings after you go home. Your nurse will tell you how to put them on and what you should check your skin for. If you need to continue anticoagulation injections at home, your nursing team will provide information and teach you how to do this. If you have any concerns make sure you speak to a nurse before you leave. It is important that you complete the prescribed course. If you develop any sign or symptoms of a clot at home, seek medical advice immediately, either from your General Practitioner (GP) or your nearest hospital’s emergency department.

Nutrition

Having a varied and balanced diet is important pre and post surgery to aid with recovery and to reduce risks of complications. A good target is to aim for ¼ of your plate being a protein source, ¼ complex carbohydrate (wholegrain rice, wholemeal bread, wholemeal pasta etc.) and ½ vegetables. When choosing meat  protein sources, try to pick lean cuts and prepare products by grilling, baking or steaming rather than frying or roasting. Non-meat sources of protein include eggs, milk products, lentils, beans and tofu. It is also important to incorporate 5 portions of fruit and vegetables per day into your diet as these provide essential vitamins, minerals and fibre required for wound healing and to help avoid complications such as constipation.

Occupational therapy

You may be seen by an Occupational Therapist (OT) before you come in to the hospital for certain orthopaedic procedures. The OT will review your home situation and discuss precautions which you may need to follow after your operation. They also identify and order equipment which you may need for your safe discharge home from the hospital. Equipment is ordered from stores outside of the hospital and may take some time to be delivered. Certain equipment may need to be privately purchased, your OT will advise you of this. Please return your heights questionnaire as soon as possible, to ensure delivery prior to admission.

Pain

You will be assisted with pain control after your operation. You will be given additional advice if you are on long-standing painkillers prior to admission, on patches or strong opiates. You will be advised about any post-operative pain concerns. When you go home you will be given pain killers which should last you for up to a week. Information on how to take your painkillers will also be given to you. If you still require pain relief after this time you will need to see your GP who will discuss  further options with you.

Research

You may be contacted to discuss research at The Royal Orthopaedic Hospital, which takes place to improve patient care and develop new treatments. 
The Royal Orthopaedic Hospital routinely collects and stores leftover tissue from surgery, that would otherwise be disposed of, in a Research Tissue Bank so that it can be anonymously provided to support ethically approved research studies. Research is completely voluntary and opting out will not affect any of the care you receive. Should you wish to opt out of any research activities, please let us know by contacting the research team via email on This email address is being protected from spambots. You need JavaScript enabled to view it.. 

Preparing for discharge

You will be informed about when and where your discharge will take place after your procedure. You will only be discharged home once you have completed all assessments safely. If following these assessments you are requiring further assistance or rehabilitation the ward staff will discuss this with you and liaise with other agencies as appropriate. When you are ready to return home, make sure you have everything you need for your recovery. Make sure that you have plenty of food, drinks and other essential items in your home. Buy food that is easy to prepare, such as frozen ready meals, cans of soup or beans, and staples, such as rice and pasta. Arrange your home so that you do not have to climb, bend or reach for items. If you live alone you will be able to go home alone. The therapists will make sure you are safe and independent with all tasks e.g. washing, dressing and kitchen activities.

Physiotherapy

Following your surgery you may be seen by a physiotherapist or given a physiotherapy information sheet. Physiotherapy is a very important part of your post-operative treatment and will speed up your recovery. Physiotherapy helps to restore movement to near normal as possible as well as building strength in the muscles around the area where you have had surgery. Physiotherapy treatment can range from:

• Advice and education about your surgery
• Exercises
• Assessing mobility and issuing of walking aids
• Stairs assessment
• Hydrotherapy

It is very important that you follow the advice and exercises that you are given by the physiotherapists so that you get the best outcome from your surgery.

Digital Patient Information System

Whilst you are an inpatient at The Royal Orthopaedic Hospital, a Digital Patient Information System is available at your bedside, for you to use during your stay, for free. You can connect with your loved ones, access entertainment services, view information to support your recovery and keep up to date with Trust and Charity news. 

This system is provided for free as it has been fully funded by The Royal Orthopaedic Charity. You can find out more by visiting www.rohcharity.org

More information

Useful sources

• Ask your doctor or nurse
• NHS website
• NHS 111

Useful contact numbers

• Main hospital switchboard - 0121 685 4000
• Outpatients - 0121 685 4153
• Pre-Operative Assessment Clinic (POAC) - 0121 685 4035
• Discharge Liaison Service - 0121 685 4000 extension 55204
• PALS - 0121 685 4128

Car parking

Parking is available at Gate A and C. Further information about parking can be found on our website www.roh.nhs.uk