Building Models of Care
The aim of perioperative care is to deliver the best possible care for patients before, during and after major surgery. Perioperative care is a natural evolution in healthcare using existing skills and expertise within the NHS to provide an improved level of care throughout the perioperative period.
Multi-disciplinary perioperative teams
The perioperative team can be led by doctors from various specialties, including anaesthesia, surgery, acute medicine, cardiology, and care of the elderly. They will provide evidence-based perioperative care, driven by robust audit data. GPs and surgeons will have a single point of contact to ensure the individual needs of complex patients are carefully coordinated from the decision to offer surgery, through to the weeks and months after the procedure.
Perioperative care teams will lead the assessment and preparation of patients for surgery to optimise the treatment of co-existing medical disease. Teams will plan care in hospital, provide advice and support during the days after surgery, and review patients in clinic when they return home to ensure all harmful consequences of surgery are fully resolved.
The perioperative team would provide an additional level of care for those patients who need it. This would include assessment and treatment before surgery, as well as individualised care in the days, weeks and months afterwards.
Perhaps most importantly, this team provides a single point of contact for surgeons and GPs coordinating the care of these complex patients.
The complete model
This complete model of care does not yet exist in the NHS, but there are numerous examples of hospitals, which have successfully implemented some of its key components. In the pages that follow, we describe some of these success stories, as well as identifying the gaps in care and exploring how a joined-up pathway would work.