A new study looking at the landscape of elective surgical hubs in England has been published as a result of a collaboration between the GIRFT programme and The Health Foundation.

Published in The Bulletin of the Royal College of Surgeons of England, the study – entitled Elective surgical hubs for helping the recovery of elective services: a national survey in England – notes the variety of operational models in the 87 hubs open at the time of the study and the fact that many hubs that predate the COVID-19 pandemic developed in an organic manner.

Key priorities for further research are identified, including:

• identifying the optimal configuration of a hub;
• identifying barriers to offering enhanced care, to help minimise inequity of access to hubs;
• whether the clinical specialties represented in a hub meets the needs of its population; and
• a financial evaluation of the different models of hub delivery in relation to the quality of care delivered.

Researchers at the University of York are currently undertaking the MEASURE study, funded by the National Institute for Health and Care Research (NIHR) to try to answer some of these questions.

The GIRFT elective surgical hubs programme is supporting the increase in this model of care and there are now 108 such hubs in operation across England.

A recent study on the Social Science Research Network (Preprints with The Lancet) details further work by The Health Foundation on evaluation of the impact of elective surgical hubs on efficiency and productivity. The research examined the impact of surgical hubs on the rate of operations carried out by NHS trusts, comparing those that had recently established a hub and those that had a hub before the pandemic. It concluded that:

• In their first year, the 31 trusts in England with newly opened hubs undertook 21.9% more high volume low complexity elective surgery (such as hip replacements and cataract removals) than they would have done without a hub. This amounts to around 29,000 more procedures than expected at these trusts during this time.
• In the year following the last Covid lockdown, the 23 trusts which had established a hub pre-pandemic undertook 11.2% more elective surgery (of all kinds) than they would have done without a hub. This amounts to around 51,000 more procedures than expected at these trusts between April 2021 and March 2022.

As well as higher treatment volumes, evidence was found of shorter stays in hospital, suggesting that hubs also have the potential to improve efficiency in elective care delivery.

GIRFT’s authors for the most recent GIRFT/The Health Foundation study were: Elena Bechberger, former national programme director for the GIRFT elective surgical hubs programme; Nicola Kennedy, GIRFT head of specialist implementation, elective hub development; Julie Renfrew, former GIRFT senior financial analyst; and William Gray, GIRFT academic content lead.