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Major NHS surgical capacity boost

Posted on February 9th, 2023

As part of the biggest and most ambitious catch-up plan in NHS history, an estimated 780,000 additional surgeries and outpatient appointments will be provided at 37 new surgical hubs, 10 expanded existing hubs and 81 new theatres dedicated to elective care.

It comes on the one year anniversary of the Elective Recovery Plan – since then, staff have virtually eliminated two-year waits for care while December saw the backlog go down for the first time since the beginning of the pandemic.

Surgical hubs are separated from emergency services in hospitals meaning tests and operations can continue in one place, largely unaffected by increased pressure in other parts of the hospital, such as covid and flu.

The Targeted Investment Fund (TIF) will provide almost 600 new beds (584) specifically for elective care, dozens of elective theatres which will deliver state-of-the-art treatment and nearly 90 more critical care beds across the country (87).

Since the elective recovery plan was published last year, the NHS has performed almost 120 million diagnostic tests – 6% higher than in the same period last year – and offered 13.5 million elective appointments and treatments – 9% higher than in the same period last year.

Elective care was delivered for 70,000 more patients in November compared to the same period pre-pandemic, meaning the waiting list dropped by almost 30,000 compared to the month before.

NHS National Director of Elective Recovery, Sir Jim Mackey said: “It is testament to the hard work of NHS staff that even as they’ve experienced some of the toughest months in NHS history with ‘twindemic’ pressures during winter and continued covid cases, they have made significant progress in the first year of our elective recovery plan.

“It is thanks to the hard work of staff and thanks to the fact we are a national health service that we hit the first milestone and remain on track to hit our next ambition by April– staff have taken every opportunity to bring long waits down, including through offering patients the chance to travel for their treatment.

“As part of the biggest catch-up programme in NHS history, our efforts are not stopping there and this additional capacity will ensure we continue to address the covid backlog as we increase the number of tests, operations and appointments the NHS can offer.

“As, ever patients should continue to come forward for care when they need it – using 999 and A&E in an emergency and NHS 111 Online otherwise.”

Health and Social Care Secretary Steve Barclay said: “We have made great progress in the past year in tackling the Covid backlogs, but too many patients are still waiting too long for treatment.

“These new surgical hubs speed up access to treatment for hundreds of thousands of patients up and down the country – providing 780,000 additional surgery and outpatient appointments.

“Bringing together the skills and expertise of staff under one roof will ensure we keep pace with future demand and rapidly reduce waiting times, getting patients access to vital procedures when and where they need them.”

Urgent cancer referrals have been at record levels since March 2021 with over a quarter of a million people (264,391) checked in November, with more than nine in 10 people starting treatment within a month.

Cancer is one area in which treatment capacity will be increased, with Basildon Hospital expanding lung cancer surgery capacity and Royal Preston adding a new theatre to carry out various cancer surgeries.

King George’s Hospital surgical hub at Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT) will benefit from the developments with £14m of funding being spent on adding two new theatres to the hub.

The hub in Ilford focuses on the six specialities that make up 70% of the trusts waiting list – general surgery, ENT, trauma and orthopaedics, ophthalmology, urology and gynaecology.

It carried out more than 7,600 surgeries last year, helping reduce the number of those waiting more than two years for treatment at BHRUT to zero.

In Cambridge University Hospitals NHS Foundation Trust (CUH), three new operating theatres are on target to open this summer at Addenbrooke’s Hospital to help cut waiting lists for routine orthopaedic operations – such as knee and hip replacements and will be located next to P and Q wards which were opened in Oct 2021.

These wards will provide 40 dedicated surgical beds for patients undergoing planned orthopaedic surgery and once the hub is completed, it will increase orthopaedic capacity at CUH by 20%, carrying out around 2,700 procedures a year.

Mr Tim Mitchell, Vice President of the Royal College of Surgeons of England, said: “This is excellent for patients, it is also positive news for surgeons who have shared with us their frustration at not being able to get patients in for their operations due to a lack of theatre capacity.

“These new surgical hubs will allow NHS staff to build on the hard work that has already been done to reduce the backlog left by Covid and it will also bring us closer to meeting the target of no patient waiting more than 18 months by April this year.”

The hubs will mainly focus on high volume low complexity surgery and will help address variation across the country to give patients great control over their treatments.

The new capacity delivered by the funding so far is part of an NHS commitment to increase elective activity by 30% on pre-pandemic levels by 2024/25, including offering patients faster clinical advice, as set out in the elective recovery plan.

Rory Deighton, director of the NHS Confederation’s acute network representing NHS trusts said: “Trust leaders remain committed to clearing the treatment backlogs and have shown already that when the conditions are right the NHS will deliver for its communities, having made sure that virtually everyone who had waited two or more years for a procedure received one ahead of the national target last summer.

“While winter pressures and the intensifying waves of industrial action present heavy challenges for the NHS, staff will give the 78-week target their all, making sure they put the new surgical spaces to good use.”

Rachel Power, Chief Executive of the Patients Association, said: “It is good to see progress being made in reducing the numbers of patients experiencing long waits for treatment as part of the NHS Elective Recovery Plan, and there’s still more to do.

“So we welcome services dedicated to the treatment of patients who have been waiting for hip, knee or other kinds of elective surgery and we would like to see patients involved in the design, development and expansion of the hubs to ensure that each of these 37 hubs meet the needs of local communities.

“We are currently talking to a hub about how we can support its partnership with patients, to ensure services meet patients’ needs and expectations, so we know there is a great willingness within the NHS to partner with patients to make surgical hubs successful.”

The NHS continues to expand diagnostic capacity, announcing last month that GPs can carry out direct access to cancer tests via the additional volume provided by Community Diagnostic Centres.

Dozens of the ‘one-stop shops’ have already been introduced in hospitals and town centres across the country since July 2021, which are on track to provide at least three million tests this year.

There are plans to open up to 160 in total over the next two years, with around nine million annual checks delivered by the end of 2025.

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