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
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.
Affiliations
University Hospitals Birmingham NHS Foundation Trust
Date
2025-04-08
Type
Article
Subject
Collections
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. 2026 Feb;108(2):117-124. doi: 10.1308/rcsann.2024.0003. Epub 2025 Apr 8.