Pre-operative psychological intervention for patients receiving hip or knee replacement Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust

Following an operation, poorly managed pain can lead to further medical problems, increased length of stay in hospital, and poor patient and carer experience. 

This project, led by Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, identified patients at high risk of post-operative pain or psychological problems before they had hip or knee replacement surgery. These high-risk patients were offered psychological support to improve their anxiety, mood and expectations of surgery, with the aim of enhancing their recovery and pain management, and reducing how long they spent in hospital.

Screening at the pre-operative assessment stage identified which patients needed to be referred to a clinical psychologist for a maximum of three sessions, for techniques such as cognitive behavioural therapy, mindfulness and relaxation.

Of 113 patients screened, 47 received the intervention and had a reduced average length of stay at the Royal Bournemouth Hospital (108 hours) compared with the 66 patients who did not have the intervention (142 hours). Pain as a reason for delayed mobilisation after surgery and delayed discharge also reduced in the intervention group, and patient feedback was very positive.

Excellent communication was identified as a key driver for the success of this project, including the development of a patient information leaflet, posters and a patient story video.

Based on the clear benefits in terms of proactively equipping patients to manage their own health care needs, as well as improved patient flow through the hospital and associated cost savings, Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust has agreed to secure funding to enable this support service to continue long term.

Contact information

For more information about this project, please contact Dr Elaine O’Shea, Consultant Anaesthetist, Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust.