Surgical Hubs Can Cut NHS Waits and Deliver More Surgeries: Health Foundation

A ward at the Royal Liverpool University Hospital, Liverpool, England, on Oct. 3, 2014.Peter Byrne/PA Wire

NHS surgical hubs can deliver more operations for patients waiting for an elective surgery and help reduce waiting lists, a healthcare think tank has said.

Over a million patients, waiting to be admitted to hospital for treatments, such as a hip replacement or cataract surgery, could see their waiting time cut and experience a shorter hospital stay. This can be achieved due to the “pivotal role” of elective surgical hubs, according to the analysis by the Health Foundation.

Patients waiting for their elective surgery, often in avoidable discomfort and pain, can be treated sooner and more effectively, researchers suggested.

“With the waiting list in England standing at 7.6 million, 1 in 9 people are waiting for care they need—often with worry, pain or discomfort. It is therefore vital that we understand and implement the most effective ways of reducing the backlog of care. The NHS has sought to decrease waiting times by setting up surgical hubs to increase access to operations,” said Charles Tallack, director of data analytics at the foundation.

Hospitals Within a Hospital

Surgical hubs are dedicated units within existing hospital sites that offer common operations and procedures. Some are standalone hubs and are based in separate buildings. The hubs meet the same standards of care and safety as all NHS hospitals.

These specialised “hospitals within a hospital” carry out planned surgeries using ringfenced staff and resources.

“This effectively separates elective care into two pathways: a hub focusing on high-volume low-complexity (HVLC) cases, such as cataract removal, tonsillectomy or hip replacement, and the rest of theatre space freed up for more complex cases,” said the Health Foundation.

An HVLC programme was introduced by the NHS Getting it Right First Time programme in May 2021. Backed by £1.5 billion in government funding, it has so far delivered 108 surgical hubs operating across the country, with a further 26 due to open by the end of 2025.

Planned surgeries, such as tonsillectomy or knee replacement, can be sidelined when there is a surge in demand for emergency care. This can often take place during a bad winter or during a pandemic. But, the Health Foundation study found that surgical hubs can prevent longer waiting times for elective surgery patients.

In their first year, the 31 trusts in England with newly opened hubs carried out 29,000 more procedures than they would have done without a hub. It represents an 21.9 percent increase in the volume of HVLC surgeries during this time.

In the year, following the last COVID-19 lockdown, 23 trusts with established hubs undertook 11.2 percent more elective surgery (of all kinds) than they would have done without a hub.

The study also found evidence of shorter stays in hospitals, which suggest that hubs have the potential to improve efficiency in elective care delivery.

The Health Foundation study used datasets on surgeries taking place at NHS acute hospital trusts between April 2018 and December 2022. The study excluded the 12-month period from April 2020 to March 2021 during UK government COVID-19 lockdowns when elective activity was halted or reduced.

Policies

The research could be “valuable” to policymakers, as they seek solutions to cut NHS waiting times, said the foundation.

The newly elected Labour government has prioritised cutting NHS waiting times and securing 40,000 more appointments every week. In its promise to “put the NHS back on its feet” Labour has vowed to use spare capacity in the independent sector to ensure patients are diagnosed and treated more quickly.

In his first statement as newly-appointed health secretary in July, Wes Streeting committed to delivering the “shortest waits and highest patient satisfaction in history.”

“With the new government having staked its credibility on tackling the NHS waiting list, our research suggests that surgical hubs could play an important role in helping to deliver on this,” said Tallack.