Behind every elective surgical procedure is a dedicated Pre Operative Assessment (POA) team working to make sure patients are physically and emotionally ready for theatre.
Made up of nurses, healthcare assistants, allied health professionals, operating department practitioners and administrators, the POA team works closely with anaesthetists to review each patient’s health, carry out essential checks and ensure they are fit for surgery.
Most surgeries require anaesthesia, which allows procedures to be carried out safely and without discomfort. To make this possible, patients must be carefully assessed to confirm they are well enough for both the surgery and the anaesthetic: these assessments take place in our pre-operative clinics at Tunbridge Wells, Maidstone and Fordcombe hospitals and help to reduce risks and prevent last minute cancellations.
Across Maidstone and Tunbridge Wells NHS Trust (MTW), the team sees more than 18,000 patients each year, playing a crucial role in supporting safe and effective care.
What happens during pre-operative assessment
During their appointment, patients have a thorough review of their health. This includes reviewing medical history, discussing previous operations and anaesthetics, allergies and any existing conditions such as diabetes or high blood pressure.
The team records observations and carry out additional checks such as blood tests, electrocardiograms and routine screening for infection.
Patients are also given clear guidance about their medications, including what to continue and what to stop before surgery.
For some patients, further investigations are needed. The team can refer to specialist services including Cardiology and Respiratory teams, or arrange more detailed assessments for those undergoing major surgery. This approach means clinicians have the most up to date information to plan safe and effective treatment.
Alyson Monkcom, Pre Operative Assessment Lead Practitioner, leads the service at Maidstone and Tunbridge Wells hospitals, bringing over 20 years of combined pre-operative and anaesthetic nursing experience to the role.
“Our role is to make sure every patient is as safe and prepared as possible before surgery,” says Alyson. “We take everything into consideration, including medical history and any health conditions, so we can help make their surgery experience as smooth as possible.”
Digital innovation
In 2024, the Trust became the first in the UK to introduce iPro, a system that digitalises the anaesthetic pathway.
Once a patient is listed for surgery, they are sent a secure link to complete an online health questionnaire. This allows important information to be shared in advance, helping clinicians identify any risks early and plan care more effectively.
For many patients, this reduces the amount of time needed in clinic and means some assessments can be carried out over the telephone.
Patients are encouraged to complete the questionnaire as soon as they receive it, as the link is time sensitive. It is important patients have an up-to-date email address recorded with the hospital to access this service.
Ongoing support every step of the way
Support from the Pre-Operative Assessment team continues right up to the day of surgery. Patients are given a contact number and encouraged to get in touch with any questions, helping them feel informed and reassured ahead of their procedure.
From the first assessment through to admission, the team works behind the scenes to ensure every patient’s journey to theatre is as safe, smooth and stress free as possible.
“It can feel daunting being told you need surgery,” adds Alyson. “Our team is here to guide patients through every step and we encourage people to share any concerns so we can support them fully.”
Working together to provide outstanding care
The Pre-Operative Assessment team is made up of specialists passionate about providing the best care and ensuring patients are safely prepared for surgery.
“I am proud to lead our Pre Operative Assessment service. Completing your health questionnaire helps us plan your care safely, reduce delays and ensure you get the right support at the right time. Our POA team is experienced, compassionate and committed to providing the best possible care for every patient.” – Dr Jon Linzner, Clinical Lead Consultant Anaesthetist
“One of the most rewarding parts of pre-operative assessment is knowing that every conversation, every check and every intervention contribute to safer care and better outcomes for patients. Teamwork is at the heart of everything we do as we share the same goal of delivering patient-centred care. I am incredible proud to work alongside such an amazing team.” – Aly Monkcom, Lead Practitioner
“As a paramedic, it’s great being able to work within a diverse and multi-disciplinary environment. This role has shown me how transferable our skills are from pre-hospital to elective surgical care, and I feel very fortunate to be part of such a friendly and supportive team.” – Maria Marsh, AHP
“Working in POA TWH is very interesting and rewarding. Every day, nursing staff help patients to be safe for their anaesthetic for surgery. This sometimes can involve a lot of communication with other departments and GPs. Patient safety is the most important thing.” – Sue Winter, Clinical Co-ordinator
“I am incredibly grateful to be part of this department. Everyone is so nice and respectful, and the teamwork is amazing. I highly value the community we have here. I am gaining so much experience and grow both professionally and personally every day. This is such a fantastic place to work.” – Iwona Trakul, Healthcare Support Worker.
“I joined the nurse/practitioner-led Pre-Operative Assessment team from the private sector in 2019 and have loved watching the team grow in experience and knowledge over the last six years. I love working with the wonderful group of professionals.” – Emma Parkes. Sister