Optimising the surgical pathway

We are dedicated to making the surgical pathway work as efficiently as possible to deliver the best possible outcomes and experiences for patients. Perioperative care is key to this – encompassing all the care patients receive around their operation, from the moment surgery is contemplated, through to hopeful full recovery.  

Each year, demand for surgery grows, with millions undergoing procedures, and an increasing proportion of them being high-risk patients.  

Unfortunately, many surgical pathways are affected by inefficiencies, including higher than necessary levels of cancellations, postponements, complications, and extended hospital stays as well as avoidable readmissions.  

By implementing better perioperative interventions and processes before and after surgery, the surgical pathway can be transformed. These interventions have been proven to improve patient outcomes and enhance the efficiency of the NHS.  

Key interventions include:

  • pre-screening
  • prehabilitation  
  • comprehensive geriatric assessment
  • shared decision making
  • enhanced recovery
  • discharge planning
  • day case surgery

Anaesthetists have a lead role in delivering these interventions, working collaboratively within multi-professional teams to provide joined-up, patient-centred care.  

Our commitment

We are dedicated to the promotion and development of better perioperative care across the UK. While aspects of it already exist within the NHS (and HSC in Northern Ireland), we believe its delivery should be made the norm across the UK.  

The Centre for Perioperative Care (CPOC) is central to delivering this ambition. CPOC is a partnership of leading Royal Colleges, health charities, and patient groups. It is hosted and supported by the RCoA.  

What we are calling for  

  • UK Governments to mandate, encourage, and facilitate the adoption of surgical pathway efficiencies.  
  • Transformation funding to embed interventions to optimise the surgical pathway.  
  • National, integrated perioperative care workforce strategies in each of the UK nations.  
  • Health regulators such as the CQC, to include efficiency practices and outcomes in their assessment frameworks.  
  • Comprehensive data collection and analysis to drive improvements, enhance efficiencies, and support better patient outcomes.

Learn more

  • The CPOC manifesto provides a concise summary of the state of perioperative care, the improvements needed, and our calls to action.  
  • The CPOC submission to the NHS 10 Year Health Plan is a detailed proposal outlining how optimising the surgical pathway will help meet both short- and long-term challenges in the health system.