1. West Hertfordshire Hospitals NHS Trust Enhanced Recovery – Helping Patients get better sooner after surgery West Herts NHS Trust Enhanced Recovery Team 17 th June 2010

2. West Hertfordshire Hospitals NHS Trust Aims Provide information on where WHHT is in implementing Enhanced Recovery Agree how Primary Care can further support the patient experience through engagement in the Enhanced Recovery Partnership Programme.

3. West Hertfordshire Hospitals NHS Trust Overview What is Enhanced Recovery? Benefits of Enhanced Recovery What WHHT has achieved to date Benefits of Primary Care engagement Next Steps Contact details

4. West Hertfordshire Hospitals NHS Trust A new approach to the preoperative, interoperative and postoperative care of patients under going surgery Evidence based approach involving a selected number of individual interventions which when implemented as a group demonstrate a greater impact on outcomes. What is Enhanced Recovery?

5. West Hertfordshire Hospitals NHS Trust Benefits of Enhanced Recovery Empowers patients to be a partner in their own care Improved patient experience Improved Quality –Clinical outcomes –Early detection of complications –Quality standards met –QUIPP initiative

6. West Hertfordshire Hospitals NHS Trust Benefits of Enhanced Recovery Productivity –Reduced length of stay –Increased capacity Team working –Cross organisational working –Opportunity for service redesign –Map of Medicine and pathway improvement/redesign

7. West Hertfordshire Hospitals NHS Trust What WHHT has achieved National innovation site Implementing in –Colorectal Surgery –MSK – Hips & Knees –Gynaecology – Hysterectomy –Urology Positive outcomes –Proactive Multi Disciplinary Teams in place –Agreed Care Pathways in place –Positive patient and staff feedback –Reduced length of stay –Reduced readmission rates –Social Services engagement

8. West Hertfordshire Hospitals NHS Trust Benefits of Primary Care engagement Manage patient expectations Optimise patient health prior to referral – “Fit for List” Enhance the patient pathway and experience further Further opportunities for service redesign and joined up working across the Local Health Community National support from the DoH for innovation sites Cost savings and financial benefits

9. West Hertfordshire Hospitals NHS Trust Where do we go next? Generic: –“Fit for List screening” –Implementation and development of Map of Medicine and agreed care pathways –Engagement and involvement in Project Groups and Enhanced Recovery Board Gynaecology: –Diagnostics prior to referral –Low priority treatment criteria met

10. West Hertfordshire Hospitals NHS Trust Where do we go next? MSK: –Diagnostics prior to referral –Front end physio support –Low priority treatment criteria met Colorectal Surgery: –Bowel preparation – day before operation –Reducing preoperative bed days

11. West Hertfordshire Hospitals NHS Trust Contact Details ColorectalHelen Broadwell01923 244366 (1569) MSKSylvia Nawathe/01727 866122 (2918) Paula King07795 398759 GynaecologyJanette Buckley07795 398761 UrologyKaren Bowler07979 457177 Generic LeadKirsty Green01923 436229 Executive LeadRussell Harrison01923 436229 Clinical LeadRussell Griffin01727 866122

12. West Hertfordshire Hospitals NHS Trust Questions and agreed way forward