Letters and comments

There is no doubt that the process ofinformed consent should be one of the most importantaspectsofpatient-centredsurgicalcareandsomethingthatwehopeweallstrivetoachieve.However,inthiseraoftheEWTD, non-specialty specific junior surgical trainees andtheaddedtimepressureofhavingtoconsultmorepatientsinclinictomeetthe18-weektarget,whenareweexpectedto find the extra time required for this ideal standard ofcare? In our experience, pre-assessment clinics are nowoftenbeingrunbyspecialistnurses,who,althoughtrainedin possible surgical complications, are not the actual sur -geonsperformingtheprocedures.Additionally,ifthereareno contra-indications to general anaesthesia, some pre-assessment clinics are now conducted entirely over thetelephone. Furthermore, we now have pooled lists, whenthesurgeonwhoinitiallylistedapatientforagivenproce -dure is not the one who ends up performing the surgery.Patient‘ownership’,thecontinuationofsurgicalcareundera single surgical consultant, along with more time to seepatients in clinic would surely improve the process ofinformedconsent,perhapsevenmorethanRFTforms.