The Enhanced Recovery Programme

This is an evidenced based approach to help people recover more quickly after major surgery.

Originally pioneered in Denmark, the programme is now used in most elective surgery centres in the UK.

Promoted by the Enhanced Recovery Team of specialist nurses, this is now the established model of care for the majority of our patients undergoing primary hip and knee replacement surgery.

The programme requires the patient to:

  • Play an active role in their treatment and work with the healthcare teams to optimise their health before and after surgery.
  • Understand their operation – what will it really mean once they wake-up and start recovery as well as in the longer term. 
  • Remember to eat well, keep fit, sleep well, lose weight, stop smoking and limit alcohol.
  • See their GP or practice nurse once they have been listed for an operation to help and ensure that their health is the best that it can be, including their mental health.
  • Prepare their family and friends so they can support in the early weeks of recuperation if they can. Also, to consider if they need help from Social Services.

The hospital has various teams to help prepare patients for surgery:

  • Outpatient Surgeon and supporting staff – to start you on your journey.
  • Pre-op Assessment Nurses – ensure you are medically ‘fit’, keep you informed and help you understand the process, refer you to specialist help if required - for example the Pain Team.
  • Anaesthetist – ensures you have the appropriate anaesthesia and pain relief.
  • Physiotherapists – provide information regarding mobility and exercise and provide walking aids if required.
  • Occupational Therapists – provide information to ensure you are as independent as possible and you can safely manage at home after discharge.
  • Patient Flow Team – provides specialist help for those with more complex needs and prepares for any Social Service referrals after surgery.
  • Admission Nurses – make sure you remain fit for your operation, keep you warm, ensure you have not fasted for too long prior to you operation and give you pre-op medication.

Various techniques are used during the operation:

  • Direct wound analgesia for pain relief.
  • Minimal use of tubes into your body.
  • Minimise blood loss.
  • Specialised wound dressing.

After the operation the Ward Teams are pro-active in your recovery by:

  • Regular monitoring of your condition.
  • Keeping you warm and comfortable.
  • Encouraging food and drink as soon as possible.
  • Depending on your operation and surgeon, you may have your operated limb wrapped and cooled through a system called ‘Game Ready’. This helps minimise pain and swelling, assisting your recovery and rehabilitation. For further information click on this link: 
  • Encouraging movement including walking if possible from four hours after your operation.
  • Encouraging you to get yourself washed and dressed the next day.
  • Ensuring you are safely up and about, and ready to be discharged by day three post-operation.

For further information the lead nurse for the programme is Sister Julie Bolt who can be contacted on 01257 488280.