England's Elective Surgical Hubs managing one in seven procedures

One in seven surgeries for a range of common conditions are now performed in elective surgical hubs across England, helping to reduce pressures on other parts of the NHS, a new research report has found.

The report, Evaluating the performance of surgical hubs in England: a retrospective cohort study was conducted by Mr Cortland Linder, Professor Aneel Bhangu and Associate Professor Dmitri Nepogodiev in partnership with colleagues from the University of Birmingham. The research spans six years and 116 elective surgical hubs across England. The study focused on six procedures to assess how well hubs are getting on at providing quality care for patients.

Data from 2019-2025 showed that hubs are providing increasing numbers of procedures, and in 2024-25, 385,482 (14.1%, or around one in seven) elective procedures were performed in a surgical hub. Most surgical hubs facilitate “high-volume low complexity” procedures, predominantly by orthopaedic and ophthalmological specialties, while higher complexity surgeries continue to largely be performed at main hospital sites.

The research team also evaluated care outcomes across surgical hubs. After adjusting for the relative quality of health of patients prior to an operation, hubs provided equally good or better care outcomes compared to similar procedures performed in an acute hospital setting.

Professor Aneel Bhangu from the University of Birmingham and lead author of the report said: “Elective surgical hubs showcase the types of targeted investment in the NHS that make a significant difference for patients and help to manage growing demand.

“Our evaluation shows how these hubs are increasingly being used to manage high numbers of low-complexity procedures and support local NHS Trusts.”

Surgical hubs help deliver surgery during winter pressures

Elective surgical hubs were also found to have a consistent role in clinical management during the busiest periods. During periods of winter pressure, monthly volume of surgery in surgical hubs was maintained while volume of surgery in acute hospitals decreased, as elective care was likely cancelled to accommodate emergency patients.

In addition, the evaluation of hubs in England also may suggest the adoption of innovation for patient benefit. The proportion of procedure performed robotically was comparable between surgical hubs and acute hospitals. Furthermore, for colorectal cancer surgery, a higher proportion of procedures were performed robotically in surgical hubs than in other NHS sites.

Mr Cortland Linder, surgical trainee and PhD researcher at the University of Birmingham, said: "Surgical Hubs have become a key component of NHS elective recovery and in preventing cancellations during busy winter months. As hubs continue to develop, understanding their impact on surgical training will be important to ensure future workforce sustainability."