Enhanced Recovery

I am in charge of Enhanced Recovery in my NHS Trust (London North West University Healthcare NHS Trust) for all joint replacements. 

What does the term ‘enhanced recovery’ mean?  

Enhanced recovery is the name given to a programme that aims to get you back to your normal health as quickly as possible after a major operation.  

We have looked at all the evidence of what you and the hospital can do before, during and after your surgery to help give you the best chances for a quick and full recovery.  

This should get you home sooner.  

The details will vary depending on what operation you are having and which hospital you are being treated at, but will include:  

• Improving your fitness levels before your operation if there is enough time.  
• Treating any other long-term medical conditions.  
• Reducing the time you are starved for by giving you water and carbohydrate drinks before your surgery.  Giving you drugs to prevent sickness after surgery. 
• Giving you the best pain relief during the operation. 
• Using local anaesthetic blocks or regional anaesthetics where possible. 
• Giving you the best pain relief afterwards to get you moving quicker allowing you to start drinking earlier.  
• Reducing the time you have catheters and drips.  
• Teaching you exercises to help you recover after your operation.  

By following an enhanced recovery programme, there are usually fewer complications after surgery. There is also less chance of you needing to go back into hospital again. 

What enhanced recovery means for you 

• Taking an active role in your recovery – following the advice of the clinical team.
• Being positive about your recovery.
• Starting normal activities e.g. eating, drinking, toileting, walking (with supervision initially), as soon as possible after surgery.
• Making sure that before you come into hospital for your surgery, that you have organised any help that you will need at home, after you are discharged from hospital.
• Being aware of your discharge date prior to coming in for surgery.

How will this benefit you? 

Patients who actively participate in their recovery: 

• Feel better, sooner.
• Leave hospital sooner.
• Return to normal living sooner.

How will we help you to achieve this? 

• You will be helped to stand, within a few hours of your surgery, on the day of your surgery where possible.
• You will be helped to walk on the first day after your operation 
• You need to complete your exercise programme as recommended.

To ensure a safe and timely discharge home, we will ensure that: 

• Your blood count (HB) is checked to see that it is at an acceptable level.
• Your bladder and bowels are functioning correctly.
• You can walk unassisted with walking aids.
• You are able to walk up and down steps (where applicable).
• Your pain relief is sufficiently controlled.