Greater Manchester

ERAS+ Enhanced Recovery After Surgery

Project closed

Please note: This is no longer an active Health Innovation Manchester project

Patients undergoing surgery at six Greater Manchester hospitals will be prepared for the experience in the best possible way using the Enhanced Recovery After Surgery (ERAS+) programme. The surgical pathway builds on the success of the in-hospital programme but expands it to include six weeks of pre-surgery patient preparation and post-hospital recovery six weeks after, with patients and their family supported through a Surgery School.

There are around 250,000 high-risk elective major surgeries a year in England and Wales and there is a post-operative pulmonary complication risk (PPC) of up to 30%.  Complications, such respiratory failure or pneumonia, can increase the length of stay in hospital and reduce life expectancy after surgery.

The ERAS+ programme places the patient at the centre of their own recovery and supports them to be dynamic in their own care. It encourages increased activity, better nutrition, oral healthcare and the practice of chest exercises to help reduce chest problems. It aims to reduce complications post-surgery, with evidence suggesting a reduction in pulmonary complications by 50%, reduce the length of stay in hospital by around three days and improve quality of life for patients for six to 12 months after major surgery.

Trusts participating in ERAS+ are Manchester University NHS Foundation Trust, Stockport NHS Foundation Trust, Bolton NHS Foundation Trust, The Pennine Acute Hospitals NHS Trust, Salford Royal NHS Foundation Trust and The Christie NHS Foundation Trust.

Case Study: Sarah Lowe's Story

Sarah Lowe says the ERAS+ programmed helped her feel “empowered” before undergoing

Sarah, aged 51, who lives in Whalley Range with her husband and three children, was diagnosed with ampullary cancer after being admitted to Manchester Royal Infirmary with jaundice.

She said: “I was given two to three weeks’ advanced notice of the surgery to remove the cancer and what helped me most was the support I received through the ERAS+ programme.

“It helped me feel mentally and physically prepared for surgery.”

Sarah Lowe ERAS+ Patient

She added that she was introduced to a team of people who helped with nutrition and fitness and attended “surgery school” where she had an extensive talk, visited the unit and was able ask any questions she may have.

Sarah continued: “I felt empowered. I was part of the team preparing me for my surgery, not just a person this was all happening to.

“The programme let me take charge of my own care and feel that I was able to influence the outcome of my treatment with little things that I could do while in the hospital bed.

“I was told that something as simple as brushing our teeth and using mouthwash could help reduce the chances of a contracting pneumonia.

“Working with a dietitian I put back on some of the weight I’d lost and I was also able to build up my fitness so I was as physically ready for the operation as possible.”

Sarah added that she believes other patients should consider the ERAS+ programme.

“I would really encourage other patients to embrace the programme and know that they can make a difference.

“The fitter they are going into the operation the better their outlook afterwards.”

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