Views and experiences of healthcare from people who had subacromial decompression / keyhole shoulder surgery

Most people we interviewed were very happy with the care they got from doctors, nurses and physiotherapists. The process of being referred to hospital by a GP was often the most difficult part, particularly if it felt slow, though people were usually pleased with the care they were given once they were in the hospital system.

Some people were given injections and/or physiotherapy before they were referred to hospital for X-rays and other tests to see if they were eligible for surgery. This was sometimes a frustrating time because they were in pain and the treatments they were trying (painkillers, physiotherapy and/or cortisone injections) did not ease it.

Sue describes having a steroid injection. It only eased the pain for a few hours. X-rays showed a build-up of calcium which was causing the pain.

Age at interview 48

Gender Female

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Nicola was prescribed various painkillers by her GP when her shoulder first started hurting but they did little to ease the pain. She then had physiotherapy and two cortisone injections. The first injection eased the pain for about 6 months but the second helped only for around 2 months. It was at this stage that surgery was discussed. She’d been in pain for over a year.

Nicola was at her wits end’ with pain. She could hardly use her arm but still had to work and look after her four children.

Age at interview 46

Gender Female

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Olive took painkillers and had injections. She went back and forth to the GP and hospital over several months. She recalled that being referred was a problem but, once referred, the care was good and everything about the surgery was explained to her:

Olive would have liked to have been referred sooner. When the injections wore off, she felt that the doctors couldn’t do anything to help her.

Age at interview 76

Gender Female

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A few people talked about telephone consultations they’d had before they were referred to hospital by their local doctor. These consultations aimed to assess whether a hospital appointment would be appropriate or other courses of action.

Sue had a phone consultation set up but ended up having to chase it up when no one called her. Everything “went smoothly and very quickly”, though, once she started having hospital appointments.

Sue was disappointed when her phone consultation failed to take place twice. She felt that she wasn’t getting any further with finding help.

Age at interview 48

Gender Female

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A doctor talks about the telephone consultations used to assess patients.

Ken had to wait over 3 months to get a hospital appointment after being referred by his GP, which was “annoying”. Once he started having appointments, though, he had ‘no complaints whatsoever’ about the care he was given:

Waiting for a hospital appointment was hard work. Ken was in pain, felt grumpy, short tempered, and wary of going out in case anyone bumped into him.

Age at interview 46

Gender Male

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Pre-operative assessment

When participants knew they were eligible for surgery, having tried other treatments first and after X-rays had identified a problem, the next appointment was usually the pre-operative assessment. At this appointment routine medical tests are carried out, including blood tests, a urine test and an ECG to record the electrical activity of the heart.

A doctor explains what happens at the pre-operative assessment.

This video explains more about the pre-operative assessment:

Many people praised the information they were given and said that the pre-operative assessment was well organised and well-structured. Mary described it as a “roundabout” of seeing different health professionals and that it was “fantastic”.

Sue describes what happens at the pre-op assessment. She had lots of tests and saw different professionals. It was well thought out and thorough.

Age at interview 48

Gender Female

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Alan had a checklist of tests to have and professionals to see, which was ticked off as he went along. It was well timed, structured and informative.

Age at interview 63

Gender Male

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Most people were happy with the tests and information given at the pre-operative assessment. There was usually little waiting around as participants had one test after another. Margaret, though, ended up waiting and felt disappointed, describing the appointment as “horrendous”:

Margaret couldn’t understand the nurse who went through a long form with her. He seemed to be going through the motions. There was a lot of hanging around.

Age at interview 71

Gender Female

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In hospital

Most people we spoke to were pleased with the care they’d been given in hospital by health professionals, including nurses, physios, consultants and anaesthetists. Jasmine said they were supportive and caring, Beverley that she had “good care”, and Olive that she recovered so well that she had no need to see the professionals again. Beverley, like a few other people, noted that the timing of tests and surgery went well and there were no delays.

Manuel’s care was near perfect. The doctors and nurses were very good and he felt well looked after.

Age at interview 44

Gender Male

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One woman said she had “excellent care” that she “couldn’t fault”. All the professionals were good and she was particularly “impressed” with the surgeon and registrar who explained everything she needed to know about the operation. The ward care was also good and the hospital was clean. David felt that his healthcare had been “excellent” and the hospital was “spotless”. He said he’d been “very impressed” despite the negative publicity the NHS often gets.

Mary commented that both doctors she saw on the day of the operation were professional and friendly, and that one of them was light-hearted, which was “what you want on the morning. You’re a little bit anxious or whatever about what’s going to happen during the day. So being very smiley and friendly was really just what was needed.”

For Wayne, the care was “gold star all the way… 10 out of 10”.

Mary was very impressed with her care. She was in a room with one other woman. The anaesthetist and consultants came to see her soon afterwards.

Age at interview 45

Gender Female

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Alan praised the staff he saw at the pre-operative assessment and later in hospital. He’d never had an operation before but was reassured by his mother-law that he had nothing to worry about – she went in for a knee operation on the same day:

Alan was really impressed’ with the care from professionals and with the hospital. It was brilliant’ to be in hospital for just the day. He had no problems at all.

Age at interview 63

Gender Male

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Nicola said the staff were all good and treated her as an equal. She felt “like an actual person and not just a number”:

The whole experience was brilliant. The nurses and doctors were good. Nicola felt they listened to her and explained everything in words she could understand.

Age at interview 46

Gender Female

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Rosemary was disappointed with a nurse who she felt discharged her even though she was feeling dizzy and lightheaded. Patients are not usually discharged if they are unsteady or unwell and so, if they are concerned, they should inform the nursing staff that they would like to see the surgical team or anaesthetist again.

One woman felt that a nurse had been “dismissive” when her husband asked how long the operation would be as he’d be waiting for her during this time. Other than that, though, she was “very, very impressed” with the care and “can’t fault it at all”.

Rosemary would have liked to stay in hospital overnight but felt the nurse wanted her to go home. She was feeling dizzy and didn’t feel safe to go back home.

Age at interview 62

Gender Female

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Patricia had a very difficult time after surgery and was disappointed with it and the amount of time it was taking to get a physiotherapy appointment. She still had a lot of pain and limited arm movement:

Patricia’s arm and shoulder are still very stiff. She feels that surgery hasn’t helped. She is waiting to have physio and to see the consultant in 3 months’ time.

Age at interview 69

Gender Female

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Recovery

Participants went home the same day as having surgery and had no need to contact the hospital again, only going back for a routine follow-up appointment. A telephone number was often provided in case there were problems. Some people would have liked more information on managing at home in the early stages of recovery, while others would have liked a physiotherapy appointment sooner after surgery so they could find out if they could progress to more challenging exercises. Most people were pleased to have been given a booklet of exercises and the TEPI website address so they could keep checking that they were doing the exercises correctly.

Manuel did his exercises watching the TEPI video. He felt he was having physiotherapy at home. The exercises kept him busy all day while he was recovering.

Age at interview 44

Gender Male

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The follow-up appointment

Many people talked about the follow-up appointment, which was often 6 weeks after surgery, and what happened at it (see The follow-up appointment for shoulder surgery).

A doctor explains what happens at follow-up and who to contact if there are shoulder problems after that.