Improving surgical care for patients and their families in Greater Manchester – ERAS+ GM

  • Led by Manchester University NHS Foundation Trust, in partnership with the NHS Transformation Unit Manchester, Haelo and Health Improvement Manchester.
  • ERAS+, a proven pre- and post-surgery training programme, will be implemented in six NHS Trusts in Greater Manchester.
  • Initiative to improve recovery following major surgery and reduce post-surgical complications.

Post-operative pulmonary complications (PPC) affect 1–2% of patients following surgery. But in major surgery they are the most common significant complication and can affect up to 30% of patients. PPCs usually occur within the first seven days following surgery and typically manifest as an infection, an increase in oxygen needs or respiratory failure. PPCs lead to increased length of stay in hospital and reduced life expectancy for up to three years after surgery.

Enhanced Recovery After Surgery Plus (ERAS+) aims to better equip patients and their families for preparation and recovery from major surgery. It focuses on helping patients to prepare for and contribute towards the management of their own health care. It does this by addressing the physical and psychological stress associated particularly with cancer, but also helps to avoid chest complications which are common after surgery.

The initiative has been tested at Manchester Royal Infirmary with over 1,000 patients and has been shown to reduce PPCs by 50%, resulting in a three-day reduction in length of stay in hospital and annual savings of over £0.5 million.

ERAS+ involves training to prepare for surgery, such as muscle training to increase strength, management of anaemia, and nutrition and lifestyle advice; use of the a respiratory care bundle and a stepped recovery programme in hospital; plus a structured exercise programme and focus on diet following surgery.

This Scaling Up Improvement project is implementing ERAS+ in six other NHS Trusts. It will become the standard pathway for every patient undergoing major surgery in Greater Manchester. This will mean up to 5,000 patients will benefit from the programme. Based on a one-day reduction in hospital stay, the initiative could save £1.5 million.

The project will be independently evaluated and learning will help with sharing the programme further within the NHS in the future.

Contact details 

For further information about the project, please email Dr John Moore, Consultant in Anaesthetics and Critical Care, Adult Critical Care Clinical Director, Manchester Royal Infirmary, Manchester University NHS Foundation Trust or the following contacts for specific areas: 

About this programme


Scaling Up Improvement

This programme offers £500,000 funding to supports teams to take successful interventions or approaches and deliver them at s...

You might also like...


Fixing the UK's broken social care system

The decisions we make about technology today will have implications for the entire social care system, says Lydia Nicholas, f...


Artificial intelligence in the NHS: getting the priorities right

The NHS’s new AI lab needs to focus on the needs of patients and the health system, argue Adam Steventon, Sarah Deeny, Josh K...

Press release

Health and care services face a perfect storm of pressures in the coming months

Health Foundation response to NHS England monthly performance stats for September.

Kjell-bubble-diagramArtboard 101

Work with us

We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

View current vacancies
Artboard 101 copy 2

The Q Community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more