Elective surgery waiting lists continue to place significant pressure on NHS Trusts’ clinical capacity, with planned treatment often disrupted by the demands of urgent care services. As a result, there is a growing focus on a dedicated approach that increases throughput, protects planned procedures, and improves resilience within elective care pathways.
Surgical hubs are a central part of that shift. In this blog, we explore what they are, how they operate, and their role in helping the NHS reduce waiting lists whilst improving efficiency.
What Is a Surgical Hub?
A surgical hub is a dedicated facility for elective surgery that operates in deliberate separation from an NHS Trust’s emergency and urgent care theatres. That separation protects planned procedures from cancellations caused by emergency demand.
On the hospital site, an emergency case always takes priority, and this can result in a planned procedure being cancelled at short notice, often repeatedly. Dedicated elective facilities eliminate this, ensuring theatre time is protected. Staffing is structured around planned activity. Patient pathways are designed specifically for consistency and throughput. The result is a facility that can deliver higher volumes of elective procedures than the equivalent theatre capacity located within a live hospital.
The Role of Surgical Hubs in the NHS Long Term Plan
These facilities have been a central pillar of the NHS’s Elective Recovery Strategy since the government’s 2022 commitment to deliver over 50 new Surgical Hubs that will provide at least 100 more Operating Theatres and 1,000 more beds to deliver millions more operations, backed by £1.5 billion from the government.
The Elective Care Reform Plan reinforced the Elective Recovery Strategy by identifying hubs as a central mechanism to return to the constitutional standard of 92% of patients treated within 18 weeks by March 2029.
By September 2025, 122 surgical hubs were operational in England, backed by over £1 billion in surgical transformation capital. NHS England has signalled continued capital investment beyond the initial programme, a significant development for Trusts still in the planning stages and yet to secure funding.
What Types of Procedures Take Place in a Surgical Hub?
These purpose-build environments are designed to deliver high-volume, low-complexity elective procedures. The Getting It Right First Time (GIRFT) programme identifies a broad range of surgical specialties including Ophthalmology, General Surgery, Orthopaedics, Gynaecology, Urology, and Ear, Nose and Throat.
The NHS Waiting List Crisis: The Scale of the Problem
Despite the dedication NHS Trusts and the tireless efforts of clinical teams across the country, demand has consistently outpaced the capacity available to meet it.
How Many People Are on NHS Waiting Lists Right Now?
According to The Kings Fund, waiting list and waiting times have been rising since 2012, and the constitutional standard of 92% of patients being seen within 18 weeks was last met in September 2015. Waiting lists rose sharply during the pandemic, but the more persistent challenge has been the NHS’s difficulty in expanding elective capacity quickly enough to keep pace with demand.
Progress is being made, but with more patients joining the list each month than completing treatment, the pressure on Trusts to find additional surgical capacity shows no sign of easing.
Why Current Capacity Hasn’t Been Enough
According to NHS England, the NHS delivered more elective activity in 2025 than in any previous year on record, completing 18.4 million treatments and operations, while waiting lists fell to their lowest level since February 2023.
This is a significant achievement, yet the King’s Fund reports that as of October 2025, just 62% of patients were waiting less than 18 weeks for treatment, still significantly below both the 92% NHS constitutional standard and the interim target of 65% by March 2026.
The BMA notes that general and acute bed occupancy has consistently been above 90% since September 2021, leaving little headroom for inpatient elective throughput to grow, and creating the bed pressures that routinely trigger elective cancellations across the broader surgical programme.
With the New Hospital Programme facing significant delays and capital budgets already stretched, Trusts are under real pressure to find ways of expanding clinical capacity for elective surgery that don’t depend on a decade-long build programme.
Why Surgical Hubs Are Central to the NHS Elective Reform Plan
Reducing waiting lists ultimately comes down to treating more patients than are being referred. To do that consistently, the NHS needs environments where elective activity can run at planned capacity without emergency care interruption. When elective capacity is ring-fenced and protected, emergency demand stops being a direct threat to elective progress.
The government’s Elective Reform Plan has made surgical hubs a central pillar of its strategy to restore the 18-week standard by 2029, backed by £1.5 billion of dedicated capital funding and a growing network of hubs now operational across England.
A Full Clinical Pathway, Not Just Extra Surgical Capacity
The most effective facilities aren’t simply additional theatre capacity, they’re environments designed around the entire patient journey, from pre-operative assessment and diagnostics through to post-operative recovery and discharge.
The Health Foundation found that during the first year of operation, the average rate of high-volume, low-complexity elective surgery in Trusts with new surgical hubs was 21.9% higher than expected which emphasises that a pathway-led approach is demonstrating measurable impact in delivering elective procedures.
Trusts with more established hubs showed even greater resilience, with higher-than-expected rates of elective surgery and shorter inpatient lengths of stay, suggesting that hubs also have the potential to improve overall efficiency in elective care delivery. When every stage of the process is designed specifically around elective flow, it enables more patients to be treated, shorter lengths of stay, and clinical teams operating with a level of predictability that a busy acute site rarely allows.
Modular Surgical Hubs: A Faster Route to Capacity
For NHS Trusts that need to increase elective surgical capacity without waiting years for a traditional build programme to complete, modular construction offers a fundamentally different proposition. Modular facilities can be designed, manufactured and operational in a fraction of the time of a traditionally built facility, without compromising on clinical standards, infection control, or patient environment.
Why NHS Trusts Are Choosing Modular Over Traditional for Surgical Hubs
The appeal of modular isn’t just speed, although it’s vital for tackling elective waiting lists. Modular construction also removes many of the variables that make traditional construction programmes so unpredictable. Lengthy planning processes, on-site disruption, and the risk of cost overruns that can delay or derail a project entirely.
A modular surgical hub is manufactured off-site to precise clinical specifications, then delivered and installed with minimal disruption to the existing site. For a Trust under pressure to make inroads on its elective recovery plan, that predictability can be as valuable as the capacity itself.
Are Modular Surgical Hubs a Permanent or Temporary Solution?
Modular has the capability of being both, depending on the Trusts individual requirements. Modular surgical hubs can be long-term permanent facilities that sit seamlessly into an existing estate or can be repurposed and redeployed as a Trust’s needs evolve.
This flexibility is invaluable in an NHS environment where demand evolves, sites change, and committing to a permanent structure isn’t always the right answer. What a modular solution always provides, regardless of its intended required usage period, is a permanent, fully compliant, purpose-built clinical environment.
Supporting the Business Case: How NHS Trusts Are Funding Surgical Hubs
For many NHS Trusts, the question of how to fund these facilities is the biggest barrier to getting one off the ground. Dedicated capital funding does exist, the Surgical Transformation Programme has been funded with £1.2 billion of capital from NHS England’s £1.5 billion Targeted Investment Fund, but not every Trust will secure funding or find themselves in the position to wait and find out if they have been successful. Increasingly, Trusts are finding that a surgical hub doesn’t have to be a capital purchase at all.
Why Capital Budgets Alone Can’t Close the Elective Backlog
The NHS waiting list for planned treatment has fallen to around 7.11 million treatments (6.02 million patients) its lowest level in around three years. Whilst this represents progress, it remains significantly above the levels required to restore the NHS constitutional standard.
For Trusts that need to move quickly, a capital purchase isn’t always the right or most accessible route. Hire agreements, Managed Service Arrangements, and Pulse solutions offer alternative ways to procure facilities without the burden of significant upfront capital investment. This gives Trusts more options to build a viable business case regardless of where they sit in the funding cycle.
The NHS has a clear roadmap for tackling elective waiting lists, and surgical hubs are central to it, but securing capacity quickly, without overstretching capital budgets, is where many Trusts get stuck.
MCH’s modular surgical hubs are purpose-built, fully compliant, and accessible through a range of funding models, giving Trusts a faster path to protected elective capacity when it’s needed most.
If your Trust is considering its options for elective recovery and would like to find out more about how MCH can help, get in touch with our team today.
