CHILDREN and adults across the North West are being seen quicker as surgical hubs across the region continue to deliver on their promise to increase the volume of people who can be seen, reduce waiting times and deliver more operations in shorter times.

As The Health Foundation reports on new research that shows the impact the new facilities had in their first year, trusts in the region continue to reap the benefits of the hubs delivering actual benefits to patients, tackling waiting lists and improving the care provided to patients.

NHS England North West’s Interim Regional Director, Dr Michael Gregory, said: “I am impressed every day by the effort and dedication NHS organisations and their staff across the North West are putting forward to tackle the backlog of patients waiting for care across the region.

“It is clear the legacy of the pandemic continues to put strains on our services, but NHS staff in the region work tirelessly to ensure patients waiting to be seen are seen as quickly and as efficiently as possible,” he said.

“Surgical hubs have given a new string to our bows and it has been clear, since the were first established that they have made a real impact, reducing waiting times significantly for patients, and at the same time, improving their experience of care.”

In Greater Manchester, the Elective Surgical Hub at Trafford General Hospital, run by Manchester University NHS FT and opened in late 2022, now carries out around 250 surgical procedures per week, specialising in cases such as hernia operations, children’s dental surgery and hip replacements.

Dr Greg Cook, Clinical Director at the Trafford Elective Surgical Hub said: “The impact on our waiting list has been significant with waiting times for surgery coming down and patients across Greater Manchester getting the care they need much quicker.

“Patients routinely feedback that their experience at our elective surgical hub is extremely positive, and this is helped in no small part by the fact that we have not cancelled an operation for lack of bed availability since we opened.

“Growing the elective surgical hub and improving access for a greater range of patients is one of our key aims for the future.”

The Northern Care Alliance NHS FT operates a surgical hub at Fairfield General Hospital at weekends providing ear, nose, and throat (ENT) surgery, and orthopaedic surgery to patients, and another elective surgery hub at Rochdale Infirmary, seven days a week, with specialists including gynaecology, urology, ophthalmology, orthopaedics, vascular, oral and maxillofacial, and plastic surgery all covered there.

Dr Shona McCallum, Medical Director at Rochdale Infirmary, which is part of the Northern Care Alliance NHS Foundation Trust, said: “It gives us an enormous sense of satisfaction to know what we’ve been able to speed up the time people are waiting for their much-needed operations. We know that for many people having their procedures can help them get back to living healthier and happier lives.”

Wrightington, Wigan and Leigh Teaching Hospitals NHS FT opened a new planned service at Wrightington Hospital in 2022, transforming a previously unused theatre into a state-of-the-art Elective Ambulatory Unit offering same-day care to patients at the hospital, meaning patients are assessed, diagnosed, treated and are able to go home the same day, without being admitted into hospital overnight. One patient, who had experienced this commented how they felt the surgery had been “transformative” and that they were impressed with the high standard of care they had received at the hospital.

The unit, which also offers an orthopaedic surgical hub used by other NHS organisations across Greater Manchester, allows the trust to treat more patients who have non-complex upper limb surgeries and reduce the waiting list for surgery as quickly as possible.

Wrightington, Wigan and Leigh Teaching Hospitals NHS FT also manage the Leigh Day Case Unit at Leigh Infirmary, a specialist centre focused on providing high-volume low-complexity surgery for ophthalmology, general surgery, gynaecology, and urology patients. It is also the main site for breast cancer surgery at the Trust.

Since November 2023, 1,210 extra patients have been seen at Leigh Infirmary, enabled by the increase in funding of additional theatre lists. With breast services moving to Leigh Infirmary from the RAEI site in January 2024, 298 patients have been operated on, so far, and Leigh Infirmary continues to explore opportunities for expansion with plans to increase provision for cataract surgery there later this year.

Having two surgical hubs within the Trust’s footprint demonstrates how services at WWL are optimised, efficient and delivering the best possible care and value for our patients.

In Lancashire and South Cumbria, the surgical hub at Chorley and South Ribble Hospital has been putting a dent in waiting lists in the area since it opened, helping to reduce waiting times for some of the most common procedures such as cataract surgery and hip replacements.

In addition, Lancashire Teaching Hospitals NHS FT, the trust which runs both Chorley and South Ribble Hospitals, has been able to decrease waiting times for children by offering day surgery at Chorley District General Hospital, in a specialist paediatric surgical hub, with procedures delivered on site including dental, maxillofacial, ophthalmology, ear, nose and throat, and even plastic surgery.

The Paediatric Hub used the established Elective Surgical Hub to create a pop-up children’s day case pathway, moving activity from an acute site at Royal Preston Hospital to be able to treat more children in the same number of theatre sessions, as well as transforming the existing adult day case ward to a children’s day case ward that is staffed by children’s nurses and play specialists with games, toys and posters.

In June 2023 there were 1,293 children waiting for elective procedures, which was reduced to 1,099 by April 2024. In 2022/23, 1,694 elective procedures took place at an average of 142 per calendar month, and that rose to 1,966 in 2023/24, averaging 185 a month.

Steve Canty, Surgical Medical Director, said: “I am delighted that our Paediatric Hub is now officially recognised to provide the same outstanding care that our Elective Surgical Hub has – offering our patients a better experience whilst also helping to decrease our surgical waiting times. Having both our paediatric and adult elective cases in one unit at Chorley means that we can treat more children in the same number of theatre sessions, improving patient, carer and staff experience.”

At Kendal’s Westmorland General Hospital, a four-storey extension housing University Hospitals of Morecambe Bay NHS FT’s new surgical hub will open in the coming months following a £13.7m investment. The hub features two new operating theatres, upgrades to existing theatres and an extension to their recovery areas, and new support spaces, storage and ancillary areas. The facility will support in the region of 600 to 750 patients a month initially with an aim to increase these numbers to support more patients to have their procedure quicker.

Daniel Bakey, Associate Director of Operations for the Surgery and Critical Care Group, UHMBT, said: “The development of the Kendal Elective Surgical Hub has been many years in the making and we are extremely excited to have modern, purpose-built theatres that are fit for the 21st Century.

“There are many advantages to the development of the elective Surgical Hub at Kendal, one of the main ones being that we will be able to support more routine, urgent and cancer surgery.

“We have already undertaken a significant exercise to redesign our theatre timetable and delivered a project to reduce length of stay for hip and knee replacements.

“It will also improve communication between team members because everything will be in one place in the hospital for the first time in many years.”

A surgical hub at Burnley General Teaching Hospital was initially launched in 2016, bringing together the expertise of medical professionals under one roof, but was granted a significant boost in 2022, with multi-million pound funding award to upgrade the facilities to support the trust’s effort to cut waiting lists, adding two extra endoscopy suites, and a new operating theatre, enabling the trust to provide an additional 10,000 routine booked operations and procedures each year.

The hub is separated from emergency services keeping surgical beds free planned operations, reducing the risk of short-notice cancellations, and improving infection control.

In Cheshire and Merseyside Wirral University Teaching Hospital NHS FT’s Cheshire and Merseyside Surgical Centre at Clatterbridge Hospital treated 3,000 patients in its first year and has continued to support the trust to tackle waiting lists in the years since.

In its first year, the centre’s two surgical theatres saw 1,500 urology patients, over 800 orthopaedics patients, over 350 general surgery cases, 150 gynaecological patients and 140 breast patients, all in its first year, opening a further two theatres in 2023 increasing its capacity to treat as many as 6,000 extra elective patients a year.

Over 5,000 patients have been treated at the centre since it opened, including with the brand new £2 million Da Vinci robot, enabling more patients to be treated, including those with cancer. Fully under the control of the surgeon at all times, the robot exhibits impressive dexterity and precision while being minimally invasive for the patients.

Hayley Kendall, Chief Operating Officer at Wirral University Teaching Hospital, said: “The centre has made a huge difference to the thousands of patients who have been treated from across the region and we look forward to offering this fantastic service to even more of our patients.”

A number of the surgical hubs operating across the North West have been recognised as meeting the highest clinical and operational standards as part of an accreditation scheme run NHS Getting it Right First Time (GIRFT) in collaboration with the Royal College of Surgeons of England and supported by the Royal College of Anaesthetists.

The scheme assesses hubs against a framework of standards to help deliver faster access to some of the most common surgical procedures such as cataract surgeries and hip replacements and seeks to assure patients about the high standards of clinical care provided by the hubs.

Surgical hubs at Trafford General Hospital, Fairfield General Hospital, Rochdale Infirmary, Chorley and South Ribble Hospital, Wrightington Hospital, Leigh Infirmary, and Clatterbridge Hospital have all received accreditation already as part of this scheme, with others expected to follow.

The Health Foundation’s research which looked at 108 surgical hubs across 31 NHS trusts in England, is the first significant report evidencing the clear impact of these facilities and shows their ability to improve productivity by increasing the volume of operations the NHS can deliver, reduce cancellations and the amount of time patients spend in hospitals, enabling faster discharge (often on the same day) and speed up the efforts the NHS is putting in to reducing waiting times.

The report, which can be seen in full here says:

1. 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.
2. 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.