PATIENTS with colo-rectal cancer are leaving the Royal Gwent Hospital as little as four or five days after surgery thanks to a new pre- and post-operative care programme.

Around 200 patients in the past two years have undergone the ERAS (Enhanced Recovery After Surgery) programme, which is based on better preparing patients for surgery, with a view to quicker recovery, reduced complications, and earlier return home.

More detailed checks and assessments before surgery, improved nutrition before and after surgery, encouragement of early movement post-surgery, and closer involvement of patients in their care and treatment are key aims of ERAS.

Surgeons Gethin Williams and Keshav Swarnkar have pioneered the programme in colo-rectal cancer treatment at the Royal Gwent Hospital, and it is now being included in 1,000 Lives Plus, a project that aims to build on the recently completed 1,000 Lives project to reduce deaths and incidents of harm in Welsh hospitals.

The programme can be adapted to fit other surgical specialties, and is being taken up in other parts of the hospitals and across Wales. As well as benefiting patients, the shorter lengths of stay - often half the expected period - and reduced complications, if multiplied across hospitals and specialties, could save the NHS millions of pounds.

"Studies in Scandinavia showed patients' care pathway could be changed and result in shorter hospital stays and quicker recovery," said Mr Swarnkar.

Mr Williams said the programme will not work for everyone, but has great benefits in terms of preparing patients for the process of surgery and in recovery.

Mr Swarnkar said nursing input is the "glue" holding the process together, with specialist nurses closely involved with patients from their first clinic, to being available on the telephone in the days immediately following discharge from hospital, if there are problems or queries.

Surgical nurse practitioner Carole Berger, who with colleague Novalita Alzate is one of those key links for patients, said ERAS relies on close working between consultants, nurses, phyiotherpaists, dieticians, GPs and other healthcare professionals.

"It is a team programme, and the patient is part of that process," she said.

Pioneering patient full of praise

ERAS patient Michael Waite underwent surgery at the Royal Gwent last year, to remove a section of cancerous colon, and left hospital just four days later.

"I can't fault it and I can't fault anyone involved in it, they've been great," said the 62-year-old, from Newport.

"I was picked up through bowel screening programme, and it was big shock because I hadn't thought anything was wrong.

"I was asked when I came to clinic if I'd like to take part in ERAS and I thought anything that might shorten my time in hospital would be a good thing.

"I felt very involved in things, people took the time to explain every step of the way, and it was great to know the nurses were just a phone call away when I went home."