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Improving & Enhancing Perioperative Care: Putting the individual at the heart of care

Neil Betteridge Enhanced Recovery, Patient and Public Adviser at NHS Improving Quality spoke at today’s Improving and Enhancing Perioperative Care conference on:

  • enhancing quality of the patient experience
  • involving patients and putting patients at the heart care
  • the patient perspective of “high risk” 
  • patient perspectives and moving forward  


Neil emphasised that 'Confidence of the patient is where empowerment comes from' and how important it is that the patient is supported to play an active part in their own care. Neil said that 'Support needs to start in primary care. Involving carers and family is important too'. Neil closed his presentation by stating that 'We all want the best possible patient experience, we can work towards an environment where patient focus is key'

Neil Betteridge's full presentation is available to download at the end of this page

Abstract of presentation 
‘Putting the Patient at the Heart of Care’
All surgical patients benefit from a genuinely person-centred focus to their care. However, for those 250,000 (and fast growing) people who have complex needs this approach can make an even bigger difference. People of any age who have long term conditions / comorbidities, older people and those whose daily environment does not promote healthy living are all highly vulnerable.

This presentation highlights from a patient perspective what some of these additional needs are, both those intrinsic to the individual/s and those deriving from social factors, which can be equally disabling. By ensuring that the patient is supported by the whole perioperative MDT in different ways to share the issues which are most relevant to their lives, patient experience and patient outcomes are more likely to be optimised.

From this conceptual basis, the presentation highlights concrete examples of how surgical patients can be empowered to play an active part in their care, before, during and after admission. Drawing on work carried out in support of delivering Enhanced Recovery patient pathways, the focus is on promoting an active role for all patients, which starts well before admission, eg joint schools for orthopaedic patients where individuals facing joint surgery are supported to understand what they will need to do after their intervention to optimise their recovery.

Information is therefore the most critical factor of all, but it needs to be delivered in ways which effectively promote patients’ ownership of their care. This means the timing, format and means of delivery all need to be carefully considered by various members of the MDT. Patient organisations and other non-NHS forms of support can be invaluable here, for example via the provision of high quality patient information designed and developed with patient involvement, or the provision of self-management courses. The presenter has direct experience of providing such resources and services after several years as CEO of Arthritis Care but the principles and learning are applicable across all relevant disease areas and specialties.

Finally, the presentation highlights the role of information for the MDT itself, in particular for people with comorbidities. With each member of the MDT having responsibility for distinct areas of patient care, each understanding how the work of the other impacts on the overall health of the patient is not necessarily something which can appropriately be left to the gatekeeping role of the GP. The work of the Professional Record Standards Body is highlighted, promoting appropriate access to electronic records for all relevant care providers as well as the patient. 

Patients themselves have a role to play here too, both in terms of explaining the interaction of their conditions and their medications, but also in terms of their preferences when there is a conflict of suggested solutions for differing conditions. 


Chronic Pain Policy Coalition:

EULAR (European League Against Rheumatism):

The Professional Record Standards Body:

Last updated September 2015

Neil Betteridge
After working for most of my professional life representing the interest of patients in the UK and Europe from within the third sector, I now run my own company, Neil Betteridge Associates. This offers high level, patient focused advice on a range of issues affecting the lives of patients, especially people with long-term conditions. Currently, for example, I am advising the Royal College of Physicians on the development of a new patient involvement strategy.  

I am also Patient Adviser to the Professional Record Standards Body, working with the HSCIC and National Information Board to enable the recording and sharing of electronic records to deliver integrated care and support self-care.

Current voluntary positions include being a Patient and Public Voice member of NHS England’s CRG on Specialised Pain Services; Chair of the Chronic Pain Policy Coalition; and International Liaison Officer of EULAR, the European rheumatology network.

Whilst working as CEO of Arthritis Care, and Chair of ARMA (the UK umbrella body for MSK), the Health Minister appointed me as the Patient Adviser on the 18 Weeks programme. I remain a Patient Adviser to NHS England, working with NHS IQ and NHS Elect on Enhanced Recovery, Efficient and Effective Elective Care and 7 Day Services. 

In the same period, the Minister for Transport appointed me as official adviser to the UK government on disability and transport issues, a position I held for 6 years.

Future events of interest:

Always Events®: A positive approach to Improving Patient Care
Thursday 22 October 
Hallam Conference Centre, London

British Association of Day Surgery Conference: Innovation & Quality in Day Surgery
Thursday 26 November 2015 
ICO Conference Centre, London

National PROMs Summit 2015
Tuesday 1 December 2015 
Colmore Gate, Birmingham

Measuring, Understanding and Acting on Patient Experience Insight
Friday 29 January 
Hallam Conference Centre, London

Download: Neil Betteridge full presentation

12 October 2015


    Partner Organisations

    The Tavistock and Portman NHS Foundation TrustInPracticeClinical Audit Support CentrePlayoutJust For Nurses
    GGI (Good Governance Institute) accredited conferences CPD Member ASGBI (Association of Surgeons of Great Britain and Ireland) professional partner BADS (British Association of Day Surgery) accredited conferences