16 January 2026
The MEASURE study is a multicentre mixed-methods project which aims to assess the work of high volume low complexity (HVLC) surgical ‘hubs’ in reducing elective surgery waiting lists. Patients who are considered to have low complexity in terms of surgical procedure and overallhealth have their surgery carried out in HVLC hubs, usually as day case or very short stay patients. The environment is kept separate from, and uninterrupted by, emergency treatment and trauma care. Procedures range from minor (e.g. vasectomy) to major surgery (e.g. hip replacements) across a range of specialities (e.g. orthopaedic, gynaecology, ophthalmology, urology).
Are hubs value for money?
The study uses a variety of quantitative, qualitative and mixed methods to: characterise types of HVLC hubs; explore implementation; determine impact in terms of equity, volume of patients, length of stay, waiting times and productivity; explore the impact of HVLC hubs on patients and carers, the professionals working in them and the wider NHS; compare resource utilisation, conduct a cost-impact analysis and establish whether hubs are value for money.
Service leader interviews and ‘deep dives’ on site
From late 2024 and throughout 2025, the qualitative team have conducted service leader interviews and have carried out ‘deep dive’ visits at three HVLC surgical hub sites across England. This involved using methods such as observation of all aspects of the patient pathway from pre-assessment to admission, surgery, recovery and discharge, as well as organisational aspects of hubs such as mapping the space and observing management and clinical meetings along with informal staff activities.
The team conducted formal and informal interviews with patients, carers and staff such as registered nurses (pre-assessment, ward, theatre, recovery), physio/occupational therapists, health care and support assistants, doctors across levels and speciality (e.g. anaesthetists, surgeons, consultants, registrars, SAS, trainees), operating department practitioners, clinical leaders, managers, reception and administration staff. The team also collected documents, policies and procedures to inform document analysis and observed layouts, formal and informal signage and other artefacts which further informed our analysis.
Data anysis now underway
Data analysis is currently underway for this first tranche of sites. This uses both an inductive and deductive approach guided by a coding framework informed by the literature, research questions and our preliminary data as well as the Consolidated Framework for Implementation Research (CFIR). We are also working on a qualitative evidence synthesis exploring patient perceptions of day-case and ringfenced surgery which informs our primary data collection and analysis. Following this initial data generation and analysis, we have identified further case sites in which to carry out both deep dives and lighter touch visits in 2026.
Strengthening findings
As a qualitative team, we meet regularly to discuss data analysis, share and challenge ideas and concepts and plan next steps in the research process. We also regularly meet with members of the wider MEASURE team to engage at an early stage in how qualitative and quantitative data can be best utilised, developed and integrated to strengthen findings and support outputs.