Enhanced recovery programme - after surgery

The enhanced recovery programme is about improving patient outcomes (such as how well the surgery went and how good your hospital experience is) and speeding up a patient's recovery after surgery, so you don't have to stay in hospital as long.

The programme focuses on making sure that patients are active participants in their own recovery process. It also aims to ensure that patients always receive evidence-based care at the right time.

There are four elements to the enhanced recovery programme:

• Pre-operative assessment, including planning and preparation before patients are admitted to hospital.
• Reducing the physical stress of the operation.
• A structured approach to immediate post-operative and during (peri-operative) management, including pain relief.
• Early mobilisation (moving around sooner after surgery) and nutrition (eating and drinking normal food).

This approach was originally successfully piloted in colorectal surgery. It is now being implemented for cystectomy, gynaecology and hip and knee replacements.

GPs and the Trust

An important aspect of the programme is the link between GPs and the hospital. 

We need specific patient information to be provided when patients are referred to us, so that we can carry out an efficient pre-assessment.

GPs need to be aware of the programme and have access to information in order to help set appropriate patient expectations before they are admitted to hospital. They also need to be sure that any ongoing health issues such as diabetes and hypertension are as under control when the patient is referred. In addition, GPs need to be able to contact the enhanced recovery nursing staff directly|, because patients experiencing problems after being discharged from hospital should be re-admitted directly to the ward, rather than needing re-referral or entering the system via the emergency department.

The programme also has benefits for the hospital and staff because if patients get better soon and don't need to stay as long in hospital, we can treat more patients or use our resources in a different way.