York Trials Unit, Department of Health Sciences, University of York, York, UK
Centre for Health Economics, University of York, York, Yorkshire, UK.
BMJ Open. 2024 Apr 19;14(4):e086338. doi: 10.1136/bmjopen-2024-086338.
The waiting list for elective surgery in England recently reached over 7.8 million people and waiting time targets have been missed since 2010. The high-volume low complexity (HVLC) surgical hubs programme aims to tackle the backlog of patients awaiting elective surgery treatment in England. This study will evaluate the impact of HVLC surgical hubs on productivity, patient care and the workforce.
This 4-year project consists of six interlinked work packages (WPs) and is informed by the Consolidated Framework for Implementation Research. : Mapping current and future HVLC provision in England through document analysis, quantitative data sets (eg, Hospital Episodes Statistics) and interviews with national service leaders. : Exploring the effects of HVLC hubs on key performance outcomes, primarily the volume of low-complexity patients treated, using quasi-experimental methods. : Exploring the impact and implementation of HVLC hubs on patients, health professionals and the local NHS through approximately nine longitudinal, multimethod qualitative case studies. : Assessing the productivity of HVLC surgical hubs using the Centre for Health Economics NHS productivity measure and Lord Carter's operational productivity measure. : Conducting a mixed-methods appraisal will assess the influence of HVLC surgical hubs on the workforce using: qualitative data (WP3) and quantitative data (eg, National Health Service (NHS) England's workforce statistics and intelligence from WP2). : Analysing the costs and consequences of HVLC surgical hubs will assess their achievements in relation to their resource use to establish value for money. A patient and public involvement group will contribute to the study design and materials.
The study has been approved by the East Midlands-Nottingham Research Ethics Committee 23/EM/0231. Participants will provide informed consent for qualitative study components. Dissemination plans include multiple academic and non-academic outputs (eg, Peer-reviewed journals, conferences, social media) and a continuous, feedback-loop of findings to key stakeholders (eg, NHS England) to influence policy development.
Research registry: Researchregistry9364 (https://www.researchregistry.com/browse-the-registry%23home/registrationdetails/64cb6c795cbef8002a46f115/).
英国的择期手术等候名单最近已超过 780 万人，自 2010 年以来，等候时间目标一直未达到。高容量低复杂度（HVLC）手术中心计划旨在解决英国等待择期手术治疗的患者积压问题。本研究将评估 HVLC 手术中心对生产力、患者护理和劳动力的影响。
该 4 年项目由六个相互关联的工作包（WP）组成，并以综合实施研究框架为依据：通过文件分析、定量数据集（如医院住院统计数据）和对国家服务领导者的访谈，了解英国当前和未来 HVLC 的供应情况。使用准实验方法探索 HVLC 中心对关键绩效结果的影响，主要是治疗低复杂度患者的数量。通过大约九项纵向、多方法定性案例研究，探索 HVLC 中心对患者、卫生专业人员和当地国民保健制度的影响和实施情况。使用卫生经济学 NHS 生产力衡量标准和 Lord Carter 的运营生产力衡量标准评估 HVLC 手术中心的生产力。使用混合方法评估将使用：定性数据（WP3）和定量数据（例如，国民保健服务（NHS）英格兰的劳动力统计数据和 WP2 的情报）评估 HVLC 手术中心对劳动力的影响。分析 HVLC 手术中心的成本和后果，以评估其在资源利用方面的成就，以确定物有所值。一个患者和公众参与小组将为研究设计和材料做出贡献。
该研究已获得东米德兰兹-诺丁汉研究伦理委员会 23/EM/0231 的批准。参与者将对定性研究部分提供知情同意。传播计划包括多种学术和非学术产出（例如，同行评议期刊、会议、社交媒体）以及向主要利益相关者（例如，NHS 英格兰）持续反馈研究结果，以影响政策制定。
研究注册：Researchregistry9364（https://www.researchregistry.com/browse-the-registry%23home/registrationdetails/64cb6c795cbef8002a46f115/）。
