We’re delighted to be supporting the continued rollout of the Enhanced Recovery After Surgery (ERAS+) programme across Greater Manchester.  The programme was initially developed and championed by Dr John Moore, Consultant in Anaesthesia and Intensive Care Medicine at Manchester University NHS Foundation Trust. It’s one of seven projects funded by the Health Foundation as part of their Scaling Up Improvement programme.  It was initially tested at Manchester Royal Infirmary with over 1,000 patients. Results showed a reduction in Post-Operative Pulmonary Complications (PPCs) by 50%, resulting in a three-day reduction in length of stay in hospital and annual savings of over £0.5 million.

The programme is now supporting patients at six Greater Manchester hospitals to prepare for major surgery in the best possible way. ERAS+ pre-surgery patient preparation and post-hospital recovery for the weeks before and the weeks or months after, with patients and their family supported through a Surgery School.

By placing the patient at the centre of their own care the programme supports individuals to be part of the team.  Patients are encouraged and educated at surgery school on increasing their activity, better nutrition, oral healthcare, improving wellbeing and the practice of chest exercises to help reduce chest problems. These contribute to improving patient outcomes post-operatively and fit well with the NHS Long Term plan to improve upstream prevention and provide enhanced ‘supported self-management’ for patients.

Support and information is available via the website www.erasplus.co.uk which features patient and clinician videos about ERAS+ as well as downloadable resources for both patients and professionals. There is now also available an App which provides patients with a 24/7 support, guidance and information platform with clear, attainable goals on the road to back pain relief, recovery and surgery.

“I’m very impressed with this programme. I spoke with a senior Sister at my hospital who told me about ERAS in advance of my planned colorectal surgery. I attended a “surgery school” during which nurses, a nutritionist, a physiotherapist and a consultant anaesthetist explained the benefits of ERAS, in particular aspects related to nutrition, exercise and a positive mental attitude. At the end of the session I felt optimistic that, with a few lifestyle tweaks, I would be much more likely to have a successful surgical outcome.

Also, the programme offers patients like me heavily subsidised gym membership in the area where I live to help get fitter before surgery – gym work, exercise classes and swimming. This continues even after surgery to allow patients to maintain their fitness levels and to aid their recovery and rehabilitation.

I don’t feel stressed about my forthcoming surgery.  I feel confident that, with the ERAS programme, I will have given myself the best chance for a successful outcome and speedy recovery”. Patient view.

 ERAS+ Rollout so far

Next steps

Data is being collected from all of the six ERAS+ sites in Greater Manchester using the national PQIP (Perioperative Quality Improvement Programme) tool and each site has a dedicated data collector to obtain information in relation to patients undergoing ERAS+. Haelo are leading on the evaluation of the ERAS+ programme. Early results from the data collected for colorectal ERAS+ patients are showing promising trends for increasing numbers of patients attending surgery school, and trends towards fewer PPC and reduced lengths of stay.

The rollout of the GM Cancer programme Prehab4Cancer in April 2019 will complement and enhance the offer for ERAS+ cancer patients. The Prehab4Cancer programme will provide patients with targeted interventions for physical activity, nutrition and wellbeing prior and following their cancer treatment.

The overall aim is for ERAS+ to be embedded at each hospital as standard care for patients undergoing major surgery. Several other hospitals in Greater Manchester are looking to start implementing ERAS+ for their patients.

The GM ERAS+ Team led by Dr John Moore (Adult Critical Care Clinical Director, Consultant Critical Care & Anaesthesia at Manchester Universities NHS Foundation Trust) are working across the UK and internationally with a number of hospitals to implement ERAS+.

Developed by Manchester University NHS Foundation Trust, ERAS+ is been implemented in partnership with