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8 Ways to Improve Effectiveness of Elective Hubs

“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.”

Health and Social Care Secretary Steve Barclay

In this latest instalment of our Elective Hubs blog series, we look at the dynamics that can make these centres highly effective.

Previously we spoke about when setting up or transforming an elective hub, what is its purpose? In addition to the critical aspect of treating patients quickly, efficiently and safely, there must be a focus on the mission of the hub.

As Four Eyes Insight Founder, Brian Wells explains, “productivity is key to an elective hub’s existence, therefore seeking every way to deliver care in the most effective and efficient way should be central to its ethos.”

Wells, who spent six years as Managing Director of the South West London Orthopaedic Centre (SWLEOC) and then moved on to Director of Orthopedics at Guy’s and St Thomas’ NHS Foundation Trust has gained much experience and understanding of the complexities around elective hubs and ring-fenced elective pathways.

It is this experience that led to the notion that creating an effective ethos can make a significant difference to elective hubs, highlighted in the following eight key elements:


  1. 1: Create dedicated clinical and operational teams who are masters at their skills and competencies, to create stability, “we’ve seen that elective hubs can easily lose staff quickly due to the pressures on the acute trusts – staff get pulled into other sites and there is no stability for the staff or the hub.” Wells highlights.


  1. 2: Have dedicated and accountable senior clinical and managerial leadership with strong governance processes that monitor and measure detailed quality and performance KPIs closely.


  1. 3: Be on a mission to be best in class on clinical outcomes, providing great training and, critically, delivering high levels of productivity, “to be world-class you need to be looking at, monitoring and pursuing new ways of doing things. Think about what the future of the service should look like. Are you looking at developing and modernising your pathways to meet them? Where does digital come into play and AI? These are all important elements that have a role to play in the future of the NHS – moving into a flexible, digital world.”


  1. 4: Standardise clinical pathways and protocols that safely allow the wider clinical team to extend their roles and skills. “If standardisation becomes a philosophy, everybody then knows what they’re doing and staff will understand how to make the service work productively, efficiently and above all – safely.”


  1. 5: View standardisation as a great philosophy then every effort to standardise the clinical pathways is expected and pursued.


  1. 6: Pilot, test and advance new ways of achieving higher levels of productivity, such as HVLC lists, Superlists and High-Performance lists, with an ambition to go beyond historic levels of performance.


  1. 7: Measure the outcomes of what the elective hubs do, monitoring and reflecting on these outcomes to perfect the clinical approach and pathways.


  1. 8: Acknowledge incentive schemes to reward efforts beyond BAU performance, if this is done in the correct way, incentives can be a real enabler for the whole team and service.


Elective hubs can make a huge difference to the NHS in reducing the elective care backlog. With the right level of ambition and expectation, providers can take them beyond the performance levels of an acute setting where services face daily complex challenges from emergency pressures. Wells concludes, “all staff need to invest in a vision to be the best of class, seeking opportunities to refine and advance their input to the mission. To do this the NHS need to coach and train the workforce on what it really means to deliver high levels of productivity safely and with positive patient outcomes, by sharing emerging best practices for high performance and then developing their services through an accountable improvement programme.”

Contact us today to learn more about our work with Elective Hubs


About Brian Wells

Brian is a Founder of Four Eyes Insight who trained as a Registered Nurse in the Army specialising in theatres and anaesthetics.

Following a long clinical career, he went on to hold senior management posts in the NHS including, Managing Director of SWLEOC (a centre of excellence in elective orthopaedic care), and Director of Orthopaedics at Guy’s & St Thomas’ NHS Foundation Trust where he provided senior leadership with a focus on clinical productivity, process standardisation and operational grip and control.

Connect with Brian on LinkedIn.