The 'hub' model for colorectal surgery: a viable paradigm shift?
Janardhanan, P Khalid, A Anwaar, M H Williams, R Timms, E Ward, S Karandikar, S Dattani, M
Janardhanan, P
Khalid, A
Anwaar, M H
Williams, R
Timms, E
Ward, S
Karandikar, S
Dattani, M
Affiliation
University Hospitals Birmingham NHS Foundation Trust
Other Contributors
Publication date
2025-04-08
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Introduction: Nationally, in the aftermath of the first COVID-19 lockdown, the waiting list for elective surgery is approximately 7 million. To ameliorate an evolving crisis and improve system resilience, the Royal College of Surgeons of England proposed a 'New Deal for Surgery', promoting COVID-light sites and elective hubs. We evaluate the short-term outcomes, safety and sustainability of the hub model at a large National Health Service trust.
Methods: All major elective colorectal operations performed at the hub between 8 March 2021 and 8 March 2022 were included for analysis. Pertinent data on patient demographics, operative performance and postoperative outcomes were analysed using SPSS 27.
Results: In total, 401 cases were analysed. There was one same-day cancellation because of the unavailability of beds (0.2%). Median distance displacement for patients for their primary surgery was +3.2 miles. Twenty-one patients (5.2%) required postoperative blood transfusion. One patient had nosocomial COVID-19 (0.2%), severe complications of Clavien-Dindo grade ≥3 were observed in 33 patient (8.2%) and transfer-out for higher level care occurred in 34 cases (8.5%). Forty-six 30-day readmissions (11.5%) and two deaths (0.4%) were noted. Median length of stay was 6 days.
Conclusions: The volume of major colorectal surgery at the hub, with acceptable incidence of major complication, transfer-out and minimal patient displacement, attests to the efficacy and safety of the new model.
Citation
Janardhanan P, Khalid A, Anwaar MH, Williams R, Timms E, Ward S, Karandikar S, Dattani M. The 'hub' model for colorectal surgery: a viable paradigm shift? Ann R Coll Surg Engl. 2025 Apr 8. doi: 10.1308/rcsann.2024.0003. Epub ahead of print.
Type
Article