Spread and adoption of enhanced recovery from elective surgery in the English National Health Service

By November 2013, a progress review entitled Enhanced Recovery Care Pathway reported successful national implementation in four main types of elective surgery, colorectal, gynecological, orthopedic, and urology. Thousands more surgeries were being performed in 170,000 fewer bed days. Target lengths of stay had been achieved, readmission rates had not increased, and both quality and patient satisfaction had improved. A win-win-win-win. That document includes a copy of a consensus statement signed by 17 of the UK’s health care leaders, including the NHS Medical Director and Presidents of the Royal Colleges of Anaesthetists, Physicians, and Surgeons, that concludes: ‘‘We believe that enhanced recovery should now be considered as standard practice for most patients undergoing major surgery across a range of procedures and specialties.’’