Perioperative care · UK
Enhanced Recovery After Surgery, done properly.
An evidence-based perioperative pathway — prehab, opioid-sparing anaesthesia, no prolonged fasting, early feeding and early mobilisation. Shorter stays, fewer complications, faster return to normal.
Why patients choose us
- 01
A proper ERAS pathway, not a poster
Every stage — prehab, anaesthetic, feeding, mobilisation — is agreed upfront and audited. Not just a leaflet handed out at pre-assessment.
- 02
Consultant surgeon and anaesthetist aligned
ERAS only works when the surgeon, anaesthetist and ward all sing from the same sheet. We book units where they do.
- 03
Independent, and free
We are paid by no hospital, so the recommendation is impartial and costs you nothing.
Indicative pricing
What ERAS-compliant private surgery costs in the UK.
Indicative ranges across our partner units. Send the details and we quote firm figures across two or three options.
In short
A hip replacement on an ERAS pathway: £12,500–£18,500, home in 1–3 days.
| Pathway | Indicative range | Typical length of stay | Access |
|---|---|---|---|
| ERAS-compliant colorectal resection | £14,000–£24,000 | 3–5 days LOS | Same admission |
| ERAS-compliant hip or knee arthroplasty | £12,500–£18,500 | 1–3 days LOS | Same admission |
| ERAS-compliant radical prostatectomy | £16,000–£22,000 | 1–2 days LOS | Same admission |
| ERAS-compliant gynae-oncology resection | £15,000–£25,000 | 2–4 days LOS | Same admission |
| Prehab programme (4–6 weeks) — standalone | £600–£1,600 | 4–6 weeks | Before admission |
| Consultation only (surgeon or anaesthetist) | £220–£450 | 30–45 min | Same visit |
Prices vary by hospital, by consultant, by whether prehab is bundled, and by the extent of the operation. We come back with a firm quote within one working day.
The problem
An ERAS leaflet is not an ERAS pathway.
Enhanced Recovery is standard on paper across most UK units, but real-world compliance ranges wildly. The pathway only works when every element is delivered — pick-and-mix underperforms.
-
Told to fast from midnight?
Modern ERAS gives clear fluids up to 2 hours pre-op and a carbohydrate drink. The old rule is not evidence-based.
-
Handed opioids by default?
Regional anaesthesia, TAP blocks and multimodal drugs cut opioid dose, nausea and ileus. Ask which analgesia stack is planned.
-
Prehab mentioned in passing?
Prehab needs weeks, not days — a written plan for exercise, nutrition, anaemia and smoking makes a measurable difference.
The journey
From enquiry to recovery — what happens, in order.
One clinician from first message to two-week check-in — including the prehab weeks that matter most.
Phase 1 · Before your surgery
Prehab, up to 6 weeks
Phase 2 · On the day
The operation itself
Phase 3 · After
Earlier home, guided recovery
- 01
Before
You tell us what surgery is planned
A short, confidential form. The operation, any dates, your fitness, medications and existing conditions.
- 02
Before
We match you to an ERAS-active unit
Within one working day: a surgeon and hospital where the full Enhanced Recovery Programme is standard, not optional.
- 03
Before
Prehab — 2 to 6 weeks
Exercise, nutrition, anaemia optimisation, stop smoking ≥4 weeks, alcohol cessation ≥4 weeks. Written plan, weekly check-ins.
- 04
On the day
No prolonged fasting
Clear fluids up to 2 hours before, carbohydrate maltodextrin drink pre-op. No routine bowel prep for most colorectal cases.
- 05
On the day
Multimodal, opioid-sparing anaesthesia
Regional block, epidural or TAP where appropriate, short-acting agents, goal-directed fluids, warmed to ≥36°C. Minimally invasive where possible.
- 06
On the day
Eat, drink and move within hours
Sips of water in recovery, light diet the same day, sit out of bed and walk within 24 hours. Catheters and drains out early.
- 07
After
Home earlier, back to normal sooner
Discharge criteria met, not calendar-based. Length of stay typically 30–50% shorter. We check in through the first two weeks.
Typical end-to-end: 4–6 weeks from enquiry to surgery. Length of stay: 30–50% shorter than traditional care.
When it helps
Where an ERAS pathway makes the biggest difference.
The specialties where ERAS® Society guidelines are strongest — plus the one caveat about who may need a modified pathway.
-
Elective colorectal surgery
Bowel resections — laparoscopic or open — where the full ERAS® colorectal pathway has the strongest evidence.
-
Hepato-pancreato-biliary resection
Liver, pancreas and biliary surgery with ERAS pathways cutting complications and length of stay.
-
Gynae-oncology surgery
Ovarian, endometrial and cervical cancer surgery, where ERAS is now the standard of care.
-
Urology — cystectomy, prostatectomy
Radical cystectomy and robotic prostatectomy benefit substantially from ERAS protocols.
-
Thoracic surgery
Lung resections with ERAS-thoracic pathways — early mobilisation, regional analgesia, chest drain protocols.
-
Hip and knee arthroplasty
Joint replacement is a mature ERAS field — spinal anaesthesia, day of surgery mobilisation, same or next day discharge.
-
Cardiac and emergency surgery
Increasingly applied in cardiac and even emergency laparotomy — an evolving evidence base under the ERAS® Society.
-
Red flag: not for every patient
Severe frailty, unstable cardiac disease or major cognitive impairment may need a modified pathway — decided case by case.
Pathway pillars
What actually happens on an ERAS pathway.
Eight elements, delivered together. The gains come from the stack — not any single item.
-
Prehab — get fit for surgery
Exercise, protein-focused nutrition, iron infusion for anaemia, smoking cessation ≥4 weeks, alcohol cessation ≥4 weeks. Weeks, not days.
-
No prolonged fasting
Clear fluids up to 2 hours pre-op and a carbohydrate maltodextrin drink — reduces insulin resistance and post-op nausea.
-
No routine bowel prep
For most colorectal resections, mechanical bowel preparation is dropped — safer, more comfortable, no worse outcomes.
-
Minimally invasive where possible
Laparoscopic or robotic access instead of open surgery when the operation allows — less pain, faster recovery.
-
Opioid-sparing multimodal analgesia
Epidural, TAP block, wound catheter, spinal, dexamethasone, gabapentinoids, IV lidocaine — a stack, not just morphine.
-
Goal-directed fluid therapy
Fluids titrated to cardiac output, not litres-per-hour. Avoids overload, gut oedema and delayed feeding.
-
Early feeding and mobilisation
Sips within hours, light diet same day, chewing gum, out of bed and walking within 24 hours. Drains and catheters out early.
-
Audit and ≥80% adherence
The benefit tracks compliance. Units audit adherence to every element — around 80% compliance is where outcomes flip.
Our vetted UK network
Units where ERAS is standard, not aspirational.
Consultant surgeons, anaesthetists and ward teams across central, north, west and south London, and select regional units. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every unit in our network.
-
Consultant surgeon and anaesthetist trained in the relevant ERAS® pathway
-
Ward staff briefed on early feeding and mobilisation — not overnight nil-by-mouth
-
Prehab clinic access — physio, dietitian, anaemia and smoking cessation support
-
ERAS-compliance audit run at unit level, not just a printed protocol
Safety and outcomes
What ERAS actually delivers — honestly.
The pathway is safer than traditional care, not riskier. The things worth planning are prehab time, opioid-sparing analgesia, and knowing what recovery should look like.
-
ERAS is safer, not riskier
Length of stay falls 30–50% and complications 20–30% versus traditional care. Readmissions are similar or lower — not higher.
-
Prehab needs weeks, not days
Smoking cessation ≥4 weeks before surgery, alcohol cessation ≥4 weeks. Anaemia treated in advance. Booked in a hurry means less benefit.
-
The carbohydrate drink is not optional
A maltodextrin drink 2 hours pre-op is a core element. Skipping it — or the old “nil by mouth from midnight” — undoes part of the pathway.
-
Early mobilisation is you, not the ward
Sitting out of bed and walking on day 0 or day 1 does more than any drug. Family and ward staff should expect it.
-
Opioid-sparing means less nausea, faster gut
Regional analgesia and multimodal drugs reduce opioid dose — which reduces nausea, ileus and delayed feeding.
-
Diabetes and older patients benefit most
Carbohydrate loading, glycaemic control and early feeding particularly help patients with diabetes and older adults.
-
VTE prophylaxis continues at home
Blood-thinning injections for 10–28 days after major abdominal or pelvic cancer surgery — do not stop early.
-
Adherence matters — around 80%
Pick-and-mix ERAS underperforms. The gains come when the unit hits roughly 80% adherence to every element.
-
Red flags after discharge
Fever, worsening pain, calf swelling, breathlessness or wound discharge are not normal — call the team or A&E the same day.
Reading your discharge summary
Your ERAS discharge summary in four parts. Read the last one first.
Whichever operation was done, an ERAS discharge summary keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the summary before your review, just ask.
- 01 Header
Operation, pathway and prehab summary
The operation done, the ERAS pathway used, and the prehab weeks logged before admission.
- 02 Anaesthetic
Analgesia and fluid strategy
Regional block, epidural or spinal used, opioid dose, goal-directed fluid volumes and temperature maintained.
- 03 Recovery
Feeding, mobilisation and drains
When you first ate and drank, when you first walked, and when catheters and drains came out.
- 04 Impression
Length of stay, complications, follow-up
Read this first: actual length of stay, any complications, the two-week check-in and the follow-up plan.
Recognised by major UK insurers
Cover for the underlying operation varies by insurer and by indication. ERAS itself is baked into the surgical package — not billed separately. We confirm cover before booking.
Frequently asked
Everything we get asked about Enhanced Recovery.
Quick answers on prehab, fasting, opioids, length of stay and who benefits most.
-
What is Enhanced Recovery After Surgery (ERAS)?
ERAS — also called an Enhanced Recovery Programme — is an evidence-based perioperative pathway. It bundles prehab, opioid-sparing anaesthesia, no prolonged fasting, minimally invasive surgery where possible, and early feeding and mobilisation. Overseen internationally by the ERAS® Society and in the UK by the ERAS UK Chapter.
-
Which operations use ERAS in the UK?
It started in colorectal surgery and now covers hepato-pancreatic, gynae-oncology, urology (radical cystectomy, robotic prostatectomy), thoracic surgery, hip and knee arthroplasty, cardiac surgery, and increasingly emergency laparotomy. NHS England’s Elective Recovery Plan promotes it across specialties.
-
Does ERAS actually shorten hospital stay?
Yes. Meta-analyses show length of stay falls by roughly 30–50% and complications by 20–30% versus traditional care, without an increase in 30-day readmissions. The gain depends on adherence — around 80% pathway compliance is where the benefit is fully realised.
-
Why do I get a carbohydrate drink two hours before surgery?
Because prolonged fasting worsens insulin resistance, dehydration and post-op nausea. A maltodextrin carbohydrate drink up to 2 hours pre-op is safer, more comfortable, and part of every modern ERAS pathway. It is one of the reasons the old “nil by mouth from midnight” rule has been dropped.
-
What is prehab and how long does it take?
Prehab is 2–6 weeks of structured preparation: exercise (aerobic and strength), protein-focused nutrition, anaemia treatment (often IV iron), smoking cessation for at least 4 weeks, and alcohol cessation for at least 4 weeks. Booked in a hurry, prehab is thinner — book with runway where you can.
-
Do I really need to walk on the day after surgery?
Yes. Early mobilisation — sitting out of bed within hours and walking within 24 hours — is one of the strongest ERAS elements. It reduces chest infections, blood clots and muscle loss and speeds return of gut function.
-
How much does ERAS-compliant private surgery cost?
The pathway itself is not billed separately — it is baked into how a good unit runs. Ballpark package prices in London: colorectal £14,000–£24,000, joint replacement £12,500–£18,500, radical prostatectomy £16,000–£22,000. Standalone prehab runs £600–£1,600. We confirm firm figures within one working day.
-
Is ERAS suitable for older or frailer patients?
Often it is the group that benefits most — early feeding, opioid-sparing analgesia and rapid mobilisation reduce delirium and deconditioning. Severe frailty or unstable cardiac disease may need a modified pathway agreed between surgeon, anaesthetist and geriatrician.