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The enhanced recovery model IS innovative and stems from a US-based model already rolled out at at least two other Trusts nationally. Others are looking at it now too.

It will work if all professions, not simply surgeons and orthopods, are geared up to deliver both pre and post op packages of care. And this costs more money to deliver, and yes, you only save the LOS bed days £ if a) demand is managed or reduced as a result, i.e. bed days aren't filled up by other patients; b) beds are removed; and c) if there aren't any other recurrent costs to deploy and sustain.

This model should be delivered to improve quality and patient care, but it doesn't save any money, and certainly isn't achievable if Trusts continue having to decrease overhead and pay costs thus reducing the opportunity to innovate.

This is precisely the type of out-of-touch leadership that is not helping the NHS but rather hindering its progress. The candle is burning at both ends and strangely appears that political leaders are watching both ends burn.