Rapid review of the effectiveness, efficiency, and acceptability of surgical hubs in supporting planned care activity

This rapid review was conducted as part of the Evidence Service’s collaboration with Heath and Care Research Wales

Next update: Update not planned

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Introduction

The COVID-19 pandemic further exacerbated disruptions to elective care services in the UK, leading to longer waits for treatment and a growing elective surgery backlog. Surgical hubs are a key element of the elective recovery strategy for the NHS and can play a vital role in reducing the elective care backlog. These hubs aim to increase surgical capacity by providing quicker access to procedures, as well as facilitate infection control by segregating patients and staff from emergency care.  

This rapid review aimed to assess the effectiveness, efficiency, and acceptability of surgical hubs in supporting planned care activity, to inform the implementation of these hubs in Wales. 

Main points

How up to date is this evidence?

The review identified evidence available up until January 2023. Included studies were published between 2015 and 2022.

What we found

• Surgical hubs may be effective at improving clinical outcomes such as length of hospital stay, operative and post-operative complications, and cataract surgery quality measures in certain surgical fields. However, the evidence is heterogenous and limited.
• Evidence on the impact of surgical hubs on performance outcomes such as efficiency, utilisation/usage, volume of surgeries/treatments, performance, cancellations, and time from diagnosis to treatment is limited.
• Evidence relating to the economic impact of surgical hubs is limited.
• Evidence relating to the impact of surgical hubs on patient reported outcomes is limited but indicates there may be a positive effect on patient satisfaction and compliance.
• All the studies had methodological limitations. Many used weak methods that may not be appropriate for inferring effectiveness, as such we have only analysed comparative studies when evaluating effectiveness outcomes.

What this means

• This report has provided insights to how surgical hubs delivered services in distinct surgical areas. This may be useful when designing research or services to assist with the recovery of planned care services in the UK.
• Considering the paucity of robust evidence, further well-designed, higher quality comparative research from the UK and similar countries is needed to better understand the effectiveness of surgical hubs in Wales.

Technical information

Our rapid reviews use a variation of the systematic review approach, abbreviating or omitting some components to generate the evidence to inform stakeholders promptly whilst maintaining attention to bias. This rapid review aimed to assess the effectiveness, efficiency, and acceptability of surgical hubs in supporting planned care activity, to inform the implementation of these hubs in Wales.