Enhanced Recovery

The Improvement Academy hosted a meeting with clinicians from across the region about the use of enhanced recovery in obstetrics for elective caesarean sections. Information from the afternoon including talks from our speakers about the successful introduction of enhanced recovery and tools for implementation are available here. 


Enhanced Recovery aims to optimise multiple aspects of patient care, improve recovery and facilitate earlier discharge. Although initially described for colorectal surgery, there is mounting evidence that ER may be used effectively for women undergoing caesarean section.

A few units in the Yorkshire and Humber region have already successfully implemented ER for elective caesarean sections in obstetrics, including Bradford Teaching Hospitals NHS Foundation Trust and Sheffield Teaching Hospitals NHS Foundation Trust.

The Improvement Academy hosted a meeting, with speakers who have experience in the implementation of ER within these two units. Included in this page are presentations from speakers at the meeting as well as a number of resources that relate to CARE (Caesarean Associated Enhanced Recovery), which has been introduced in Bradford Teaching Hospitals NHS Foundation Trust.


Speaker Presentations

Evidence for Enhanced Recovery in Obstetrics and Transferability - Sarah Cooper  (2 Mb)

Sheffield Enhanced Recovery in Obstetrics - Ian Wrench (10 Mb)

Bradford CARE Experience - Debbie Horner  (13 Mb) 

The Timing of Urinary Catheter Removal after Caesarean Section (slides) (230 KB)

The Timing of Urinary Catheter Removal after Caesarean Section (notes) (45 KB)

Enhanced Recovery for Elective Caesarean Section - Debbie Horner  (630 KB)

CARE Logos


CARE Poster  
CARE Patient Information  Download  (93 Kb)
CARE Protocol  Download  (379 Kb)
Audit Tools

 Pre-implementation patient priorities  (93 Kb)

 Telephone Audit Tool  (93 Kb)

Relevant Articles

Aluri S,Wrench IJ, 2014. Enhanced recovery from obstetric surgery: a UK survey of practice. International Journal of Obstetric Anaesthesia, 23(2), pp157-160.

Wrench IJ et al, 2015. Introduction of enhanced recovery for elective caesarean section enabling next day discharge: a tertiary centre experience. International Journal of Obstetric Anaesthesia, 24(2), pp124-130. 

Patient Voice

The AHSN Improvement Academy is using an innovative method of capturing the 'voice of patients' in improving the safety of their healthcare. Read about the PRASE (Patient Reporting and Action for a Safe Environment) tool here.

Further Enquiries:

Please join the conversation at Obstetric ER Yorks Twitter page here.

Dr Vicky Brown, Patient Safety Leadership Fellow, ST5 Obstetrics and Gynaecology, Improvement Academy (vicky.brown@bthft.nhs.uk)

Dr Deborah Horner, Consultant Anaesthetist, Bradford Teaching Hospitals (Deborah.horner@bthft.nhs.uk)