It is important that patients have a good understanding of surgery-related risks, particularly for mastoid surgery, which exposes patients to the risk of very serious complications, despite addressing conditions which often have only minor symptoms.

A patient information leaflet describing the risks of mastoid surgery was prepared. However, the Hospital Patient Advice and Liaison Services team thought it was too long and complicated. It was introduced unchanged. Fifty-four consecutive mastoidectomy patients were given a questionnaire asking for their opinion of the leaflet. The leaflet was also assessed with readability formulae and the Ensuring Quality Information for Patients tool.

Ninety-eight per cent of respondents thought the leaflet's writing style was easy to understand. The majority (96 per cent) thought the length was ‘just right’. The 7 readability formulae used established readability at a grade 9 level (i.e. appropriate for a reading age of 13–15 years). The Ensuring Quality Information for Patients score was 87.5 per cent.

Despite the drive to simplify patient information leaflets, quite detailed information is sometimes required. A style which is too simple may be perceived as patronising and may encourage patients to underestimate potential risks. It is important to ask patients their opinion.

To determine whether procedure-specific brochures improve patients' pre-operative knowledge, to determine the amount of information expected by patients during the consenting process, and to determine whether the recently proposed ‘Request for Treatment’ consenting process is viable on a large scale.

A prospective, questionnaire-based study of 100 patients admitted for selected, elective surgical procedures.

In total, 99 per cent of patients were satisfied with the information received in the out-patient department, regarding the proposed procedure. However, 38 per cent were unable to correctly state the nature of the surgery or specific procedure they were scheduled to undergo. Although the vast majority of patients were able to state the intended benefits to be gained from the procedure, only 54 per cent were able to list at least one potential complication, and 80 per cent indicated that they wished to be informed about all potential complications, even if these occurred in less than 1 per cent of cases.

The introduction of procedure-specific brochures improved patients' pre-operative knowledge. Although the failings of current consenting practice are clear, the Request for Treatment consenting process would not appear to be a viable alternative because of the large number of patients unable to accurately recall the nature of the proposed surgery or potential complications, following consent counselling.