A specialist nurse can replace pre-registration house officers in the surgical pre-admission clinic.

Pre-admission clinics reduce non-attendance rates for elective surgery and help in management of surgical waiting lists. Nurse-led pre-admission clinics have been reported to be successful by simple audits of their efficiency. However data are lacking comparing such nurses with PRHOs that they are replacing leaving open questions of their safety in this role. We performed a prospective study involving 100 consecutive patients attending the surgical pre-admission clinic. We compared clerking by a specialist nurse using a standard proforma and ordering pre-operative investigations with that of PRHOs who ordered investigations as is their normal practice. The specialist nurse was as accurate or more accurate than PRHOs in taking a surgical history with the exception of noting drug doses and frequencies, and taking a full social, alcohol and smoking history. She also performed well with regard to limited physical examination, ordering investigations and assessing ASA grades. With minor modifications to our proforma we believe the specialist nurse is safe to replace the PRHOs in the pre-admission clinic.