After the decision to proceed with surgery has been taken George was asked to attend a Pre-op Assessment clinic, this clinic allows for tests to be carried out to assess the general health of the patient before a procedure. The main reason for these tests to be carried out is to identify the risk of post operative mortality, then treat, advise and encourage the patient to adjust their lifestyle. (Levy et al, 2019)

The Level of testing a patient goes through is dependent on the complexity and severity of the surgery with NICE, (2016) recommending that patients undergoing major surgeries like George have tests which include Echocardiograms (ECG), Full blood counts, Kidney function and lung function.

Additionally the anaesthetist was able to send a assessment of Georges physical condition to the Anaesthetist that would perform his anaesthesia allowing them to perform a anaesthetic assessment. 

Patient centered care 

This allows for a structure to take place around the care of George, conforming to his needs in a way that will provide him with the best care at the appropriate time.This philosophy is known as patient centred care and will allow George to have control over his own care allowing him to feel more comfortable in unfamiliar environments, additionally helping to inform those looking after George and allow them to approach him with the care he needs.(Arakelian et al., 2016)

Tests Carried out on George: