The average person in the UK will undergo four to six surgical procedures during their lifetime.

The majority of those undergoing elective surgery are physically and mentally underprepared prior to their operation. Approximately 1 in 4 people smoke at the time of their surgery. 75% of people aged 45-74 are overweight or obese. The prevalence of hazardous alcohol consumption has been reported to range from 7% to 49% prior to elective surgery and between 60%–92% of people experience significant preoperative anxiety. These modifiable risk factors significantly impact the rates of morbidity and mortality in the surgical patient.

The challenge for healthcare providers is further complicated by the COVID-19 pandemic and the disruption caused to elective surgical care. There are presently 7.21 million people waiting for treatment, a number expected to grow in the coming months. The capacity of perioperative services is finite. Increasing this to address the backlog is a substantial challenge and expected to be a rate-limiting step. This situation has effectively created a generation of patients waiting longer for treatment, with reduced pre-operative support driving reduced ‘preparedness’ for surgery.