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CPOC: Centre for Perioperative Care

The Centre for Perioperative Care is dedicated to the promotion, advancement and development of perioperative care, for the benefit of both patients and the healthcare community. In this article, Dr Louise Bates, the CPOC Fellow, explain how it does this in more detail.

One of the big barriers to making real advances in perioperative care has been traditional specialty ‘silos’ and the difficulties in getting people from different specialties to work together.

To overcome this, CPOC was formally launched in 2019. It is a cross- specialty centre, led by the Royal College of Anaesthetists (RCOA) but very much a partnership between patients, the public and professional groups. CPOC has representatives from patient groups, medical trainees, the Royal College of Surgeons, the Royal College of Physicians, the Royal College of Nursing, the Royal College of General Practitioners, the Royal College of Paediatrics and Child Health and the Association of Anesthetists.

The title ‘perioperative care’ rather than ‘perioperative medicine’ was very deliberately chosen as good perioperative pathways include and need all members of the multidisciplinary team, not just doctors. The inclusion of patient representatives at Board level was also essential: effective perioperative pathways need to revolve around the patient’s need, not those of the healthcare workers involved in it.

The pandemic has altered our healthcare system more rapidly than we ever thought possible. This disruption, whilst unwanted, does provide an unprecedented opportunity to look at how we run our healthcare system and take this chance to redesign it for the benefit of the patient. At CPOC we believe that good perioperative care is the best way to improve individual patient care, limit costs and improve population health.

CPOC’s aim is to promote and develop perioperative care and its work is developing around 6 themes:

  1. Improving quality of care
  2. Supporting patients
  3. Supporting professionals
  4. Influencing policy
  5. Technology and digital
  6. Research and innovation

Examples of the work CPOC is doing under these themes include:

Improving quality of care

  • Setting standards and guidelines for best practice eg around the perioperative management of diabetes.
  • Working to make prevention part of routine clinical practice (eg training so all healthcare workers can advise patients on smoking cessation, increasing activity levels etc).
  • Recognising the importance of surgery as a ‘teachable moment’ when people are more receptive to changing habits that will not only benefit them perioperatively but, hopefully for the rest of their life eg smoking, activity levels, eating habits

Supporting patients

  • Providing clear information and resources for patients like Fitter Better Sooner and FAQs for patients having an operation during the COVID-19 pandemic
  • Supporting and promoting shared decision making so that patients, their families and their healthcare team understand the risks, benefits and alternatives to surgery. This may help some patients avoid surgery that won’t be beneficial in their particular situation and others become fitter and readier for their surgery.
  • Supporting and promoting prehabilitation and rehabilitation. This is so patients get the best possible result from surgery. For some, pre-operative lifestyle changes (exercise habits, nutrition and smoking cessation) may persist, leading to long-term better health and quality of life.

Supporting professionals

  • Bringing together high-quality educational resources
  • Developing perioperative care e-learning for all levels and specialities

Influencing policy

  • Promoting perioperative care at a national level
  • Highlighting and explaining the idea of perioperative care in the media

Technology and digital

  • Looking at how technology can improve communication between healthcare professionals and between healthcare professionals and patients.
  • Using Big Data to increase our knowledge of at-risk individuals and what interventions work best

Research and innovation

  • Identifying what works for patients, healthcare professionals and the team, with educational, economic and service implications.
  • Publicising new data that emerge.
  • Working with eg National Institute of Academic Anaesthesia (NIAA) and the Perioperative Quality Improvement Program (PQIP)

In the UK these ‘themes’ link closely with key national aims: the NHS Long Term Plan (2019) puts the patient at the centre of decisions about their own care and stresses the need for seamless care and collaborative working between healthcare professionals and organisation, and the Institute for Healthcare Improvement’s Triple Aim of better population health, better care for individuals and lower costs through improvement.

A recent, groundbreaking development is the publication of our evidence reviews looking at the evidence base behind perioperative care. This is the first time such evidence has been brought together at such a scale and demonstrates that multidisciplinary perioperative care is associated with high quality clinical outcomes, reduced financial cost and better patient satisfaction.

CPOC is a new, enthusiastic and evolving body and is very keen for you to be involved. We want to hear about your experiences of setting up or running perioperative services and the barriers you faced and how you overcame them. We are building a network of local perioperative leads in UK hospitals: your trust may have one but if not and you are interested please get in touch.

If you want to get in touch or find out more: cpoc@rcoa.ac.uk

Twitter: @CPOC_News

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This article is from the free online course:

Perioperative Medicine in Action

UCL (University College London)