This is a patient management plan to enable patients to get better as successfully and quickly as possible after surgery.  Before the operation patients are educated on what to expect after surgery and given goals.  During the surgery the anaesthetist and surgeon does everything possible to keep surgical trauma and stress to a minimum.  After the surgery, patients are encouraged to eat and drink and mobilise as soon as possible.  Chest physiotherapy is instituted and the patient is encouraged to take a responsibility in their recovery rather than passively lying in bed.  This has been a particular medical culture change in bowel surgery but has brought huge benefits for patients with reduced post-op complications and quicker return to normal activity.  There are also large benefits for the local health economy as hospital stay, drug costs and community care costs are markedly reduced.