North London Partners in health and care

Surgical hubs help fast track surgery in NCL


Over the past three months, north central London (NCL) hospitals have been working hard to create additional capacity in the system through the development of surgical hubs. These hubs have been established for six specialties, which include ear, nose and throat (ENT), general surgery, gynaecology, ophthalmology, orthopaedics and urology. Since their establishment NCL has started to see the impact on waiting lists. All NCL health care staff involved in providing care at these hubs are committed to patients getting the surgery they require to get back on the road to health and recovery.

The locations of hubs are:

  • University College Hospital London (UCLH) Grafton Way Building (opening soon): operational hub for ENT and orthopaedics
  • Highgate Hospital (UCLH): operational as a general surgery hub from mid-September 2020 and gynaecology since mid-October 2020.
  • Royal Free London (RFL):
    ophthalmology (cataracts) hub at Edgware Community Hospital In place from early October 2020
    urology hub operational at Chase Farm since early November 2020
    orthopaedic hub at Chase Farm in place before the summer
  • Moorfields Eye Hospital (MEH) (City Road and St Ann’s): ophthalmology (cataracts) hubs since August and September 2020 at respective Moorfields locations.
  • Royal National Orthopaedic Hospital: orthopaedic hub in place prior to the regional programme
  • Marie Stopes: urology hub for vasectomies only operational since October 2020

The surgical hubs have been established on existing hospital sites in coronavirus protected environments, bringing together dedicated teams of staff to provide safe and high quality elective care. Located separately from emergency or Covid-related care the risk of infection during surgery is minimised. This has been beneficial in the recent Covid-19 second wave, as the NHS has been able to continue to provide safe and efficient surgical care in the hubs despite Covid-19 increasing in the community.

Orthopaedic

The two new centres established for planned orthopaedic surgery are permanent changes, which have been made by the Governing Body of the North Central London Clinical Commissioning Group following public consultation.  Two partnerships for orthopaedic surgery have been formed; UCLH and Whittington Health will work together to provide inpatient and day surgery across the partnership. North Middlesex University Hospital (NMUH) will work with the Royal Free London (RFL), with inpatient surgery at Chase Farm and day surgery at both sites. Outpatient appointments and pre-surgery patient education classes will also happen across these hospitals.

The Royal National Orthopaedic Hospital (RNOH) will continue to work as part of the network, performing super-specialist orthopaedic surgery.

The five other specialties are temporary changes to support patients being able to access planned surgeries in a Covid-safe environment. 

Ophthalmology

The three ophthalmology hubs (two at MEH locations and one run by RFL at Edgware) are already having tangible impacts for patients. All three hubs have increased cataract capacity, as well as, running cataract drives, the cataract drives alone have delivered over 700 additional cataract procedures.

ENT

In preparation for UCLH’s new hospital building in Grafton Way, opening imminently, adult and paediatric ENT services have been consolidated at UCLH. The ENT provision currently offered is providing RFL and UCLH patients with excellent care and starting to reduce the number of 52 week wait patients across north central London.

General surgery and gynaecology

NCL have established the general surgery and gynaecology hubs at Highgate Private Hospital. Highgate has worked with the NHS throughout the pandemic to support maintaining NHS elective services and has a Covid protected site ideal for providing high volume general surgery and gynaecology pathways. Over the past three months, UCLH, RFL, Whittington Hospital and North Middlesex University Hospital have all been accessing Highgate to access hub capacity in either gynaecology, general surgery or both. The consolidation of these specialties into a single site for high volume, low complexity surgical care has the potential to streamline services and reduce waiting times for patients. 

Urology

Urology services have also taken bold steps to improve capacity across the system. NCL Urology Network made the decision that all NCL patients should be offered vasectomies through the provider Marie Stopes and since then over 50 patients have already taken up this service. This has allowed the other urology hub at Chase Farm Hospital site to focus on other high volume pathways and enabled the sector to see more urology patients.