What is behind the rapid rise of NHS surgical hubs?

What is behind the rapid rise of NHS surgical hubs?

BMJ Open has published our report on interviews with twelve NHS senior leaders. The article describes their explanation for the quick, successful introduction of surgical hubs. And what this means for future changes in the NHS.

COVID-19 led to very long waiting lists for non-emergency surgeries across England. In response, NHS England and the ‘Getting it Right First Time’ (GIRFT) programme introduced High Volume, Low Complexity (HVLC) surgical hubs. The twelve senior leaders we interviewed were directly involved in their setup.

Key findings
We analysed the twelve interviews and found four themes explaining the rapid adoption of surgical hubs across the NHS:

• A ‘window of opportunity’: COVID-19 reframed the backlog as an acute national crisis. This triggered investment and sped up the adoption of the hub approach.
• Respected leaders and co-created, data-driven procedures: Respected NHS clinicians led the initiative and used co-created, evidence-based protocols to shape the hubs. This created interest and trust among their colleagues.
• Supportive, flexible implementation: The leaders made sure national coordination was supportive, instead of top-down and punishing. Local teams had freedom to adapt the hub model to their specific circumstances.
• Peer-to-peer accreditation: The leaders used a collaborative accreditation process. It showcased best practices and created a thriving network for shared learning and continuous improvement across NHS Trusts.

Future changes
Our study highlights that a crisis can trigger major changes in a healthcare system. However, long-term success relies on clinical credibility, relational work, and trusted data. The surgical hub model offers a blueprint for future NHS reforms by combining clear national direction with local adaptability. Future studies should investigate how well hubs work as part of a routine system. They should also check how experiences of hub staff compare with the views of senior leaders.

Read the publication