Manchester consultant awarded NHS Innovation Accelerator Fellowship to roll out cost-saving enhanced recovery programme

Dr John Moore, Consultant in Anaesthetics and Intensive Care Medicine at Central Manchester University Hospitals NHS Foundation Trust (CMFT), has been awarded one of eight prestigious NHS Innovation Accelerator (NIA) Fellowship to roll out the successful enhanced recovery surgery pathway ERAS+.

Each year, more than 200,000 major elective surgical procedures are performed in England and Wales, which carry a post-operative pulmonary complication risk of up to 30%. This can lead to increased length of stay and reduced life expectancy.

ERAS+ works by better equipping patients and families in their preparation for and recovery from major surgery, including advice and structure for training on exercise, nutrition, lifestyle and oral healthcare, with a focus on the six weeks prior to and the six weeks post-surgery. It also delivers bespoke educational tools including information videos and the multi-disciplinary led ‘Surgery School’, for healthcare professionals who deliver enhanced preparation for major surgery.

The aim of the NIA is to support the adoption of evidence-based and cost saving innovations that provide solutions to key challenges in the NHS. Through this partnership it is hoped these innovations can be implemented in a faster and more systematic fashion through the NHS into clinical practice for demonstrable patient and population benefit.

ERAS+ was implemented as part of a pilot across 700 patients at Manchester Royal Infirmary in 2014. The pathways successfully demonstrated a reduction of over 50% in postoperative pulmonary complications and in post-operative length of stay by three days; an annual saving of £300-500,000. Subsequently John, with the help of TRUSTECH (CMFT’s innovation service provider) and the Greater Manchester Academic Health Science Network (GM AHSN), applied to a number of funding schemes, including CMFT’s internal Proof of Concept fund (PoC), and the NIA scheme and was successful with both. CMFT’s PoC will fund the development of an ERAS+ based app, and the NIA scheme will assist with further development and spread of the app and ERAS+.

Now, with the support of NIA Fellowship John, who is also Adult Critical Care Clinical Director, and his team want to adopt the ERAS+ pathways across Greater Manchester as part of the Healthier Together programme as well as to other centres across the UK, focusing on the scaling-up implementation and sustainability of ERAS+, as well as taking advantage of mentorship opportunities to further develop diffusion strategies at the regional and national levels.

John Moore explains:

This is a tremendous national rubber stamping of the ERAS+ innovation that has been developed in Manchester at CMFT. With the support of the NIA there is now great potential to scale and spread at speed across the NHS. The ERAS+ team is ready for the challenge!

GM AHSN’s Executive Medical Director Donal O’Donoghue added: “Greater Manchester AHSN strongly supports the ERAS+ programme and recognises its potential to improve outcomes for patients. Through empowering patients to take control of their own recovery, and to utilise the support networks around them, this innovation reduces the time it takes for patients to recover after surgery. A shorter time spent in hospital lowers the risk of infection and complication – with benefits for health as well as increased efficiency in the NHS. This is one of the most impactful innovations I have seen so far in my time as a mentor on the NIA programme, and I would like to see ERAS+ spread across the whole of Greater Manchester, and beyond.”

Sir Bruce Keogh, NHS England’s National Medical Director, who founded the programme said:

 With rising demand and escalating costs, innovation is not an option but a necessity if we are to build a sustainable NHS. The innovations selected for this programme have the potential to deliver better value for the taxpayer whilst making patient interactions with the NHS safer and more personal.

The NIA is delivered in partnership with NHS England and the 15 Academic Health Science Networks across England.

Read more about Dr John Moore’s ERAS+ project on the NIA website