



National Theatre and Perioperative Care Programme
The National Theatre and Perioperative Care Programme collaborates across all interdependent national programmes that support the delivery of high-quality, efficient surgical care. The programme plays an integral role in improving and, where necessary, standardising theatre and perioperative services across England.
This national programme is working to improve and standardise the quality of perioperative care services in England so that all patients on an elective or emergency surgical pathway have a good experience of perioperative care; that cancellations or delays to surgery for avoidable clinical reasons are minimised; and that the perioperative period is used as an opportunity to improve health and reduce health inequalities.
Since the programme’s establishment, several national best practice guides have been published and numerous interactive webinars and forums have been hosted to bring together medical, nursing and operational colleagues. The aim of each guide and interactive session has been to bring colleagues together and create a collaborative space to share insights, explore challenges and discuss practical solutions for enhanced theatre and perioperative efficiency.
Perioperative care pathways include components such as shared-decision making, preoperative assessment, prehabilitation, multidisciplinary working and follow-up after surgery. UK and international evidence shows that perioperative care pathways offer a range of benefits for patients and the wider NHS:
Benefits for patients
- people feel more prepared for surgery;
- people are more empowered, active and involved in their care;
- better communication between people having surgery and healthcare teams;
- greater patient satisfaction with their care; and
- fewer complications after surgery, meaning people may feel well sooner and are able to resume their day-to-day life and employment more quickly.
Benefits for the NHS
- reduction in the length of time people stay in hospital after surgery;
- less use of intensive care units after surgery;
- fewer complication rates after surgery, helping the NHS make better use of resources; and
- reduced cost of care (or cost the same as conventional care).
Draft reference guide for early screening, risk assessment and health optimisation
Following changes in the requirements for perioperative care in the new NHS Standard Contract, early screening and health optimisation will need to be introduced for all inpatient pathways by April 2024. The National Perioperative Care Programme has developed guidance supporting providers and integrated care boards to implement early screening, risk assessment and health optimisation for patients waiting for surgery.
This guide builds on the clinical guideline Preoperative assessment and optimisation, published by a cross-specialty, multidisciplinary working group (the Royal College of Anaesthetists, Royal College of Surgeons of England, Royal College of General Practitioners and the Centre for Perioperative Care) in June 2021.