A letter from Professor Ramani Moonesinghe (PQIP Chief Investigator):

"It is a privilege to present this 5th PQIP Cohort report to you.

Yet again, the team are blown away by the efforts of our collaborators at the 173 hospitals which have provided

high quality data to PQIP. Even more so, we are grateful and humbled by the trust which 53,478 patients have
placed in us, consenting to participate in PQIP and completing patient-reported data.

We are living in times of change. I am writing this in early June – by the time you read it, we will have a new
government, whatever its political leanings.

However, there are challenges in the NHS which will persist beyond the election, and which perioperative care
has the opportunity to help meet.

The waiting list continues to rise, population health continues to decline and yet we are all working harder and
faster than ever before.

For this to be sustainable, and for patient care and outcomes to improve despite these challenges, we need to
implement the highest quality principles of perioperative care.

Our top improvement priorities, again highlight some high impact interventions which can support two key goals:
reducing late cancellations and postponements before surgery, and reducing complications and length of stay
after surgery. If we achieve these goals, we create capacity to reduce the size of the waiting list.

Every PQIP hospital team will have its own challenges and priorities, but from a national perspective we continue
to highlight:

● anaemia and perioperative blood management
● diabetes care
● individualised risk assessment
● DrEaMing as a simplified approach to Enhanced Recovery
● using data for improvement.

Thank you to all our collaborators for their efforts, and thank you to the PQIP central team for the hard work they
put into compiling this report, particularly Adam, Aiman, Dom and Eimhear.

We look forward to working with you on delivering the ambitions set out in this report."