This practice considers the care of the surgical patient to start even before the initial consultation, and extends through to the formal postoperative follow up visit. We therefore support the patient through all these stages, until the patient is considered to no longer require our assistance. We also strongly believe that patients should be given as much relevant information as possible.

Upon scheduling the initial consultation, the patient will be sent (by email or post) the confirmation of the appointment details and more importantly relevant medical/surgical background information about the condition that the patient has been referred for (In most instances).
This enables the patient to read these documents and be well-informed prior to the consultation.

The patient is encouraged to bring a family member or friend to the consultation, to encourage a smooth and clear transfer of information. The patient is also encouraged to bring a list of questions that may arise from the previously emailed information pamphlet.

Clinical Associate Professor Ahmad approaches each referral in a holistic way. He is able to bring his knowledge and experience as a Specialist in Emergency Medicine to assess the whole patient, rather than just concentrating on the presenting disease or condition.

During the consultation, Mr Ahmad uses diagram (drawn or Internet-based) to illustrate the condition and surgical approach to the management. Appropriate operative videos are shown to help explain the surgery. Mr Ahmad typically would use his educator experience in teaching medical students and junior doctors to ensure that the information is provided to the patient in terms that is comfortable to the patient and their accompanying support.

At the end of the consultation, should an operation be indicated, the patient will be provided with the relevant instruction for preparation for the surgery. This includes the fasting and admission time, as well as any other relevant information. An additional 'Discharge Management Pack' is also included.

Pre-habilitation
Appropriate patients will be referred to the other members of the team to optimise their preparative state prior to surgery (please see Pre-habilitation).

This consists of information about the general and specific management protocol for patients upon discharge, detailed information on the discharge medications and suggested regime to use the postoperative analgesia.

This practice realised that patients often are concerned about what to do after they have been discharged from hospital and some complications may emerge after the patient is discharged. This may affect their recovery and delay the return to “normal” living. To assist patients to maximise their recovery, this practice employs Post-Operative Care Consultants (Registered General Nurses) to liaise by phone with the patient, after they are discharged.

For patients who are staying overnight, on the day after the surgery a Post Operative Care Consultant (Registered General Nurse) accompanies Mr Ahmad on his ward rounds. The nurse will then contact the patient 3–4 days after they are discharged from hospital. Any concern in regard to the postoperative recovery is identified and immediately managed. Should it be deemed necessary, an urgent follow-up can be scheduled.

The patient is formally reviewed by Mr Ahmad, prior to being totally discharged from the care of the practice.
Communication with the General Practitioner (GP) and referral source
The GP is continually informed by this practice and kept ‘in the loop’ throughout the patient care. This may be in the form of letters generated during each appointment or other contact method.
Typically,

• A letter is sent from Mr Ahmad to the GP after the initial consultation.
• A copy of the Operation note is sent to the GP.
• A discharge summary is faxed to the GP upon the patient’s discharge from the hospital.
• A letter will be sent to the GP from the Post Operative Care Consultant after they have rung the patient at home.
• A postoperative follow-up letter is written to the GP when the patient comes into the clinic for review post surgery.
• Appropriate patients will be referred to a rehabilitation physiotherapist to assist their recovery and reduce the incidence of hernia recurrence.