Enhanced recovery

Who can benefit from enhanced recovery?

Some of the principles of enhanced recovery can be applied to all cases of surgery. However, for some conditions and procedures, specially designed pathways help patients benefit from the principles more effectively.

Types of surgery and conditions where enhanced recovery programmes are currently used include:

• breast – such as removal of a breast because of breast cancer
• colorectal – such as removal of the rectum because of bowel cancer
• gynaecological – such as removal of the womb (hysterectomy)
• musculoskeletal – such as a hip replacement or knee replacement
• urological – such as removal of the prostate gland (prostatectomy) because of prostate cancer

Some hospitals also offer enhanced recovery programmes following cardiac or thoracic surgery.

The enhanced recovery programme

If you need to have an operation, ask whether there's an enhanced recovery programme in place for your condition at the hospital you're going to.

To enhance your recovery from surgery, it's important that you play an active role in your own care.

Important points to consider before your operation include:

• *eating well * – your body will need energy for repair
• *exercise * – being physically active before your operation will help you recover quicker
• relaxation  – try to relax and not worry about your operation
• smoking and alcohol  – giving up or cutting down will help speed up your recovery and reduce your risk of developing complications

Your GP will give you advice about getting into the best possible shape before having surgery. They'll also identify and stabilise any health conditions you have that may affect the operation.

At this stage, your GP should ensure you understand all the treatment options available to you so you can make an informed decision about whether to proceed with surgery.

In hospital, your healthcare team will advise you about what you can do to help make your recovery easier.

This may include:

• staying active – you may even be walked to the operating theatre
• drinking clear fluids or carbohydrated drinks up to two hours before your operation
• early mobilisation and early diet
• keeping an enhanced recovery diary to track your progress

Where possible, techniques that will help with your recovery may also be recommended, such as using minimally invasive surgery (keyhole surgery), local or regional anaesthesia, and minimal use of drains and nasogastric tubes.

Your overall experience should be improved as a result of high-quality care and, where possible, high-quality services, such as keyhole surgery.

After surgery, you'll also have access to rehabilitation services such as physiotherapy. This will help speed up your recovery and enable you to be discharged from hospital as soon as possible.

Depending on your operation, you may be able to go home sooner than usually expected. It's therefore important to plan and prepare for your return home before going into hospital.

Read more about having an operation.

Further information

Speak to your GP if you're considering having planned surgery. They'll advise you about whether enhanced recovery is suitable for you.

Not all hospitals offer enhanced recovery programmes, but the number that do is growing all the time.

You can read more about enhanced recovery in My role and my responsibilities in helping to improve my recovery (PDF, 1.31Mb).