Preparing for surgery during the COVID-19 pandemic

In the early stages of the COVID-19 pandemic UK hospitals had to stop all non-urgent operations including joint replacements. While some hospitals have since been able to resume some surgery, waiting lists have continued to grow as the pandemic has caused further delays and cancellations of planned treatments.

Versus Arthritis has been campaigning for the backlog of surgery to be addressed as quickly as possible. Find out more about our Impossible to Ignore campaign.

In places where planned surgery is going ahead, hospitals have altered their approach and procedures in order to keep you, NHS staff and other patients as safe as possible while still offering the same level of care. Some of the main changes are set out below.

Different hospitals have their own approach to reducing the risks posed by the COVID-19, and many have published their own guides on what to expect.

However, all NHS staff should have:

• personal protective equipment (PPE)
• up-to-date training on COVID-19
• been regularly tested for the virus.

To avoid unnecessary travel and reduce the spread of the virus, surgical teams have been advised to carry out preoperative assessments through a video call or on the phone, unless a scan or physical examination is required.

Once you have a date for your operation, your hospital will try to stick to it. However, it may need to be rescheduled if they think you’re at greater risk of developing COVID-19, or if they don’t have the facilities and resources to care for you safely.

You can learn more about the guidelines hospitals are likely to be following from the National Institute of Health & Care Excellence: NICE guideline NG179: COVID-19 rapid guideline: arranging planned care in hospitals and diagnostic services

There are things you can do to improve your health in the lead up to your operation.

Try to be as physically active as possible and do any exercises your physiotherapist or doctor has given you. By continuing to strengthen and stretch your body, particularly the part that’s being operated on, you can increase your chances of a good and speedy recovery.

You can find more advice on our exercising with arthritis pages.

Keeping active and as fit as possible can also help you manage your pain levels in the lead up to surgery. If you are struggling with pain in the lead up to your operation our advice about managing pain should help.

Being unfit, overweight or a smoker can increase your risk of complications and can make the effects of COVID-19 more severe. If you are concerned about this speak to a healthcare professional and take a look at our advice about diet and exercise.

The following services are available if you'd like support to stop smoking:

• England - NHS Smokefree
• Scotland - NHS inform
• Wales - NHS Wales - Help Me Quit
• Northern Ireland - Quit Kit

Once you have a date for your surgery you will be advised to reduce the amount of contact you have with other people.

Some hospitals recommend people isolate themselves and members of their household for 14 days before their surgery. Others may only ask you to limit your contact with other people to reduce the risk of infection, but to self-isolate for a few days before you go into hospital.

If you're asked to self-isolate before surgery you may be entitled to Statutory Sick Pay.

You should continue to take precautions, such as hand washing, to reduce the risk of exposure to the virus. If you’re not sure how best to protect yourself the NHS has a guide to keeping yourself safe during the pandemic.

A few days before your operation you will be asked to take a swab test for COVID-19. You will be asked if you are showing any signs of infection, such as a continuous cough, loss of taste, shortness of breath, or a temperature.

If you’ve been in contact with someone who has the virus you need to let your hospital know as soon as possible – even if you aren’t currently showing any symptoms.

If there is a risk you may have COVID-19 your operation is likely to be postponed, especially if you have other health problems that could increase your risk of complications.

When you arrive at hospital all staff should be wearing personal protective equipment (PPE). Depending upon their role, this could be partial face masks, gloves and aprons, or full-body protection and face shields.

If PPE makes it difficult for you to understand what’s being said, let the staff know so they can help you as much as possible.

You may be tested again for coronavirus. If you do not appear to have the virus you will be admitted for surgery.

If you test positive you will be transferred to another ward and your surgery will probably be postponed.

You may not be allowed any visitors while you’re in hospital. Instead many hospitals are asking people to stay in touch using their phones or online apps.

Your surgeon should explain how long you will need to stay in hospital after surgery if all goes to plan.

However, if hospital staff think you may have come into contact with a person who has the virus then plans to discharge you may change as infection could have an impact on your recovery.

The more you can do to keep yourself fit and healthy before your surgery, the better your chances of a straightforward recovery.

Before any plans can be made to discharge you from hospital you will need to have another coronavirus test. As long as there are no traces of the virus, you will be allowed to return home.

Your surgical team will advise you on the best steps to recovery. They will tell you how to take care of your wound and will write to your GP’s surgery to arrange treatment once you are home. They should be able to tell you exactly what aftercare to expect once you’re home.

You may need to have home visits from a doctor or district nurse to care for your wound. Any NHS staff who visit your home will use PPE.

Once you are home you should continue to protect yourself from infection. Contact your GP surgery as soon as possible if you have any concerns about your wound or think you may have COVID-19.