Wrexham hospital staff use innovative ways to help patients get fit for surgery during pandemic

Staff at Wrexham Maelor Hospital have found new ways to continue to help patients get fit for surgery in order to reduce the risk of complications following their operation.

Towards the end of last year a team of health care professionals started a programme of Prehab sessions at Plas Madoc Leisure Centre in Wrexham for patients awaiting surgery.

The sessions consisted of a supervised exercise session, diet education, wellbeing sessions and respiratory muscle training.

Due to the current pandemic the team quickly adapted their programme to continue to offer the service for patients awaiting urgent bowel, kidney and upper gastrointestinal (GI) surgery.

Consultant anaesthetist, Dr Neil Agnew, said: “We developed a really successful Prehab programme in the six months prior to COVID-19, we had really good results showing reduced complication rates, reduced length of stay in hospital and overall improved outcomes. Patients also really enjoyed the sessions.

“Unfortunately due to the pandemic we were unable to continue with the supervised programmes for high intensity exercise, and the psychology and dietician sessions in groups.

“However, we’ve realised it’s really important we carry on with this programme in a different way.

“We are looking at innovative ways of delivering Prehab and looking at video technology and providing information for patients to take home – it’s really important we do all we can to ensure this service continues for our patients.”

Wrexham Maelor Hospital was the first in Wales to offer to offer the prehabilitation programme to patients who are waiting for major general surgical procedures.

The scheme involves a whole multi-disciplinary approach that includes important input from Dieticians, Physiotherapists and Pre op Nurses.

Physiotherapist, Jo Lloyd and Exercise Physiologist, Steve O’Meara are now both based within the Pre Op Assessment area within the hospital, and work alongside Pre Op Nurse Practitioner, Lorraine Hughes.

“We have adapted our service due to the pandemic, we’ve had to be really innovative due to social distancing,” said Jo.

“We are really pleased we can still provide this programme for our patients and they are continuing to use our amazing piece of equipment, the POWERbreathe, which helps to improve breathing muscle strength, which is very important during surgery.

“Improving muscle strength can also help with reducing the risk of infections following surgery, such as chest infections.

“The patients have been using the POWERbreathe at home all the way up to their surgery, we have been in close contact with them throughout to ensure they feel supported and if they have any concerns or problems.

“If they do we can provide support to them over the telephone and we are also looking into designing an app which could provide them with even further support.”

As the gym is currently closed, Steve has had to look at new ways to encourage patients to exercise as part of the programme.

He said: “Due to the pandemic we had to adapt our exercise programme, instead of the patients being supervised in the gyms they are now doing their exercises at home three times a week.

“We see them when they come into Pre Op and we demonstrate the exercises and offer support with continuing them at home.

“During the lockdown period we have had feedback from patients that they have been exercising with their family at home, with gyms now shut it’s been nice to hear that they have all been doing this together which I’m sure has been extra support for the patient.”

Lorraine added: “All the patients that have been offered the programme have taken it up, we’ve had lots of good positive feedback from our patients.

“Patients are really grateful that this programme is available for them and that they are doing something that can lessen their risks when they come in for their surgery.”