Manchester University NHS Foundation Trust

Scaling up improvements in surgical care for patients and their families in Greater Manchester


RUBIS.Qi is working with the Health Foundation and Manchester University NHS Foundation Trust to scale up their Enhanced Recovery After Surgery Plus (ERAS+) programme to six other NHS trusts.

The programme aims to reduce post-operative pulmonary complications (PPC) which is the most common significant complication after major surgery, affecting up to 30 per cent of patients and leading to increased length of stay in hospital and reduced life expectancy for up to three years after surgery.

ERAS + aims to better equip patients and their families for preparation and recovery from major surgery. It focuses on helping patients to prepare for and contribute towards the management of their own care. It does this by addressing the physical and psychological stress associated particularly with cancer, but also helps to avoid chest complications which are common after surgery.

The programme involves training to prepare patients for surgery, such as muscle training to increase strength, management of anaemia, and nutrition and lifestyle advice; use of a respiratory care bundle and a stepped recovery programme in hospital; plus a structured exercise programme and focus on diet following surgery.

The initiative, which has been tested at Manchester Royal Infirmary with more than 1,000 patients, has reduced PPCs by 50 per cent, resulting in a three-day reduction in length of stay in hospital and annual savings of over half a million.

ERAS+ will become the standard pathway for every patient undergoing major surgery in Greater Manchester. This will mean up to 5,000 patients will benefit from the programme and could save £1.5million.

The project is being led by Manchester University NHS Foundation Trust, in partnership with the Greater Manchester Academic Health Science Network, NHS Transformation Unit Manchester, Haelo (an innovation and improvement centre) and the Perioperative Quality Improvement Programme.

Project lead: Dr John Moore, consultant in anaesthetics and critical care, adult critical care clinical director at Manchester University NHS Foundation Trust john.moore@cmft.nhs.uk 

RUBIS.Qi improvement coach:  Annie Laverty

Find out more about the project