The impact of elective surgical hubs on elective surgery in acute hospital trusts in England

Abstract

Abstract Elective surgical hubs at acute hospital trusts in England aim to increase productivity and efficiency in planned (elective) surgeries, reduce cancellations, and improve patient and staff experiences by ring-fencing care and focussing on High-Volume, Low Complexity (HVLC) surgeries. Using patient-level hospital data from April 2018 to December 2022, we evaluated the impact of new hubs (operational from 2019 onwards) and established hubs (operational before 2019) on trust-wide rates of total and HVLC elective surgeries using a generalised synthetic control methodology. Here, we show that during the first year of operation, the average rate of HVLC elective surgery in trusts with new hubs was 21.9% (95% CI 11.7%, 32.2%) higher than expected. After the COVID-19 pandemic, trusts with established hubs demonstrated greater resilience, with 11.2% higher than expected rates of total (1.3% to 21.2%) and HVLC (1.7% to 20.7%) elective surgery and 0.17 days (0.28 to 0.061) shorter than expected inpatient lengths of hospital stay. Our evaluation provides robust evidence to inform future priorities for elective care delivery.