When Robert Ormiston left hospital the day after a knee replacement, he knew his recovery wouldn’t be easy.
There would be pain. There would be days when moving around felt like hard work. There would be challenges along the way.
But what he didn’t have was uncertainty.
A few days before his operation, the 62-year-old from Eaglesham received a call from a member of NHS Greater Glasgow and Clyde’s perioperative pharmacy team. Together, they discussed his medicines, what recovery would likely feel like and how symptoms could be managed at home.
For Robert, that conversation made all the difference. And he is far from alone.
Across NHS Greater Glasgow and Clyde, a growing number of hip and knee replacement patients are benefiting from an innovative pharmacy-led service that is helping them return home sooner after surgery and feel more confident managing their recovery.
Developed by NHSGGC’s perioperative pharmacy team, the service sees specialist pharmacists contact patients around one to two weeks before surgery to discuss their medical history, answer questions and agree a tailored plan for their post-operative medicines.
Discharge prescriptions are often prepared before admission, helping ensure patients can return home as soon as they are ready following surgery.
“I was under no illusions there would be pain, but I knew what was happening,” Robert said. “The fact everything had been explained meant I was confident what I was feeling was normal. It gave me real peace of mind.”
Kieran Fitzpatrick, Lead for the Perioperative Pharmacy Service at NHSGGC, believes the conversations are about much more than simply deciding which medicines a patient will receive.
“One of the things we sometimes overlook is just how important it is to help people understand what recovery is actually going to look like,” he said.
“Hip and knee replacement surgery is a procedure where recovery is often very predictable, but if people don’t know what’s normal they can understandably become worried about symptoms such as pain, sickness or constipation.”
That preparation also helps tackle one of the biggest challenges after surgery – anxiety caused by the unknown.
“We take time to talk through those things before surgery, answer questions and agree a plan with the patient. That helps people feel prepared, involved in their care and confident in managing their recovery when they get home.”
For Robert, simply knowing what to expect made recovery easier.
“They really listened to me and took into account what I was saying, so I was happy with the medicines I would be getting,” he said. “Because of the team’s support, I also knew that what I was experiencing was normal.
“I found that really helpful and reassuring.”
What began as an effort to better prepare patients for recovery has delivered wider benefits too. The team found a statistically significant reduction in post-discharge healthcare encounters, including GP visits, hospital readmissions and NHS 24 contacts, while also helping to reduce the length of time patients spend in hospital following surgery.
Kieran believes much of that success comes from giving patients the confidence to manage predictable aspects of recovery themselves.
“Patients tell us time and again that they value having these conversations before surgery,” he said.
“When people know what’s coming and understand how to use their medicines effectively, they’re much less anxious. They feel empowered to manage their own recovery and they know where they can seek help if they need it.”
Robert also praised the practical benefits of the service, including having his medicines ready when he was discharged.
“As soon as I found out I was getting home, my medicines were there straight away,” he said. “I didn’t have to wait around for hours and I got home much more quickly.”
Several weeks on from his surgery, he is pleased with his progress and feeling increasingly confident.
Most importantly, he says, he never felt alone.
“I felt like throughout the process there was someone there for me,” he said.
“For me it was a really positive experience. If it was your first operation, or if you were feeling anxious about it, I can see how important that reassurance would be.”
Janice Watt, Interim Director of Pharmacy at NHSGGC, said:”At the heart of good healthcare is ensuring people feel informed, involved and supported throughout their care – and in this instance, the results of that approach speak for themselves.
“Patients feel more reassured and supported, while we are seeing tangible benefits for the wider service.
“I would like to thank the perioperative pharmacy team and everyone involved in developing and delivering this innovative approach for their continued dedication to improving the experience and outcomes of our patients.”
