Pre-assessment clinics for elective surgical patients are commonplace in many surgical departments throughout the UK. They are reported to help hospital trusts save money, address patients’ anxieties regarding their surgery in advance of admission and flag up any potential anaesthetic problems that might preclude surgery. We describe a closed loop audit of this service in the setting of a district general hospital providing a general ENT service. After a change in practice increased numbers of patients were pre-assessed. Cancellation rates and the need to perform ‘urgent’ investigations following admission were concurrently reduced. In our experience patient pre-assessment is useful in achieving these goals. A number of other advantages are also highlighted.