A cultural shift in anaesthetic techniques, which UCLH has helped pioneer in the UK, has significantly cut patients' recovery time after surgery, halved associated drug costs, and boosted operating theatre productivity.

Over the past three years, around 1000 operations - from joint replacements to mastectomy - have been carried out at UCLH, using regional, rather than general, anaesthesia.

Regional anaesthesia numbs all feeling in a specific region of the body - a procedure known as a peripheral nerve block - about 90 minutes before the first incision is made.

Patients are given a mild sedative to help them relax, but otherwise remain conscious and, importantly, pain-free throughout their op, without experiencing any of the side effects associated with general anaesthesia, such as fasting beforehand and prolonged drowsiness and nausea afterwards.

They don't need as much pain relieving medication, particularly morphine, and they can start their recovery sooner. In fact, once the last stitch has gone in, they can enjoy a cup of tea and a biscuit, just like 78-year-old John Croke, who chose regional anaesthesia for his second hip replacement after having the first done under general anaesthesia.

"It was a lot quicker and more pleasant than the first one I had done. I didn't feel a thing and was able to chat to the doctors and ask what they were up to," he explains. "I would definitely recommend it to anybody."

Was he worried about the prospect of being awake throughout? "I didn't mind," he says. "The most important thing to remember is that [anaesthesia] is safer this way and I know the doctors here are always doing the best for you," he explains.

John says that he heard some of the mechanics of his procedure, but patients don't have to; they can listen to music of their choice on the iPad provided.

A small pilot study of patients at the hospital who did so, showed that all of them would recommend regional anaesthesia and would prefer to have further surgery done this way in future.

The nerve block is carried out in a specially designed 'block room,' the creation of which was funded jointly by The Health Foundation and the UCLH Trustees Charity.

The first and only one of its kind in the capital, the block room is now recognised internationally as the gold standard of care for patients undergoing regional anaesthesia.

"The block room works as a processing environment, using standardised procedures, so the whole thing is seamless, quicker, and more efficient," explains Dr Damon Kamming, consultant anaesthetist at UCLH.

This means that more patients can be treated - around one extra day case per session - and it's less stressful for the surgical team and trainees learning their craft, because it's less time pressured. There are now fewer days when they have to stay late, too.

"It has improved teamwork, halved anaesthetic costs and staff time, and shortened length of stay because patients don't need so many drugs to help them recover," he says.

There may also be longer term health benefits, as the frequency of general anaesthesia has been linked to heightened risk of the recurrence of certain types of cancer and poorer memory and information processing, he adds.

Dr Kamming and his team have now developed a consistent scoring system which can be used to measure exactly how quickly and how well patients recover after regional anaesthesia and ensure the quality of care.

"In Scandinavia and Canada, patients don't expect to be asleep during their surgery, but this isn't the case yet in the UK," says Dr Kamming. "It's just a case of convincing them that this is the way to go, and including more complex surgery, while maintaining the quality and good patient outcomes we have achieved so far."

Forty-two-year-old Deborah Cassey admits she had a few qualms before having reconstructive hand surgery under regional anaesthesia.

She has had successive surgical procedures, all under general anaesthetic, for arthritis, and had always believed in the "just put me out" approach, she says.

"But now I have a sense of achievement and wonder what I was worried about," she says. "I couldn't feel my hand or arm at all, even when it was picked up and moved, and I asked them so many questions I probably talked far too much," she laughs. "If I need more surgery, I will definitely think about regional anaesthesia."