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Planned Care Innovation Exemplars

Preablement Approach to Elective Surgery

Hayley Vaughan, Manager of Reablement Services
Daisy Aldridge-White, Occupational Therapy Tech

Hywel Dda University Health Board and Pembrokeshire County Council


The project links local authority reablement services with the health board preassessment process for elective orthopaedic surgery. Elective surgery offers an opportunity to not only plan admission and surgery, but to plan the discharge and the post surgery recovery before the person is admitted, improving the system flow and the patient outcomes.



  • Set up integrated community based preablement service to support patients waiting for elective surgery
  • Enhance general wellbeing prior to surgery
  • Prevent further deconditioning
  • Optimise independent living skills pre surgery
  • Prepare patients for post surgery
  • Enable patients to live well and independently whilst they wait for their surgery
  • Reduce hospital length of stay
  • Reduce need for long term care packages



  • Referrals sent to Pembrokeshire County Council OT preablement project team
  • Patients assessed to identify those with more complex needs awaiting elective surgery
  • OT Technician visits patient, identify needs, provides mobility advice, signposts to resources, provides equipment and completes a return visit to assess outcome


Outcomes / Benefits

  • More integrated working with secondary care, primary and community services
  • Increased physical (mobility) and wellbeing (sleep and mood scores) reported by patients
  • OT Technician role proved to be integral to supporting the service and increasing capacity and efficiency

View project posters and slides from the PCIP National Showcase Event