Optimal pre‐operative care is underpinned by thorough assessment and planning. While physical preparation is concerned with the prevention of peri‐ and post‐operative complications (Malley et al. [118]), attention should also be given to the patient's psychosocial needs and how the surgical procedure may affect their overall wellbeing.

The patient's pre‐assessment includes a medical or adequately trained nurse review, which may prompt further diagnostic intervention or investigations (Boehm et al. [34]). Pre‐assessment aims to assess the patient's fitness for surgery; provide information to the patient and their family about their upcoming anaesthetic and surgery; and provide advice about diet, exercise and lifestyle (e.g. smoking and alcohol cessation) to ensure the patient is fit and optimized for surgery. Pre‐assessment is important in preparing patients physically and mentally for surgery, and it is key in improving post‐operative outcomes and reducing cancellations on the day of surgery (Pritchard [167]).

Optimizing any co‐morbidities pre‐operatively that may affect the perioperative care of the patient is a key part of the review. The patient's current health status, performance and quality of life need to be considered, and the benefits of the surgery must outweigh the potential risks (Wood et al. [234]).

Traditionally, patients were admitted to hospital 1–2 days pre‐operatively to allow for appropriate assessment, tests and investigations to be completed prior to their surgery; as such, they were not pre‐assessed in dedicated clinics. However, once they were admitted it was frequently found that patients were presenting with complicated, newly identified or inappropriately managed co‐morbidities, so surgeries were often delayed or cancelled. It was also found that a large number of cancelled operations occurred because patients did not arrive for their scheduled operation fasted. Some did not arrive because the date provided was inconvenient (due to childcare or work‐related concerns) or the surgery was no longer wanted or needed.

In light of this, pre‐operative assessment (POA) clinics were established to address these issues. The POA and planning carried out in these clinics aim to improve patient care and safety but also make the most efficient use of theatre resources and ward beds (K. Yu et al. [237]). POA is an essential part of the planned surgical care pathway. Subsequently, it has been found that providing patients with a time and place to explore their concerns and gain the information they need has increased the attendance of patients and therefore made more effective use of operating theatre time and other associated resources (NHS England [134], NHS Modernization Agency [138]).

Any data obtained during the POA provides the foundation for producing an individualized patient care plan. This may consider the patient's frailty, risk of post‐operative cognitive dysfunction, risk of infection, risk of pressure damage and risk of venous thromboembolism (VTE). A conversation with the patient during this POA is an effective way to increase the patient's awareness of certain risk factors (Almodaimegh et al. [13], Haymes [75]).

The perioperative care documentation forms an important communication tool for the perioperative practitioners. It provides detailed records of the care delivered to the patient during their surgical journey. These records are maintained and handed over to various practitioners during each perioperative phase of care.

Depending on the complexity of the surgery, the POA can be undertaken either during a face‐to‐face conversation or via telephone clinics, which are increasingly nurse led.