"The groundwork of all happiness is health." - Leigh Hunt

Forty thousand more appointments and 'surgical hubs' per week, but will it fix the NHS?

Chancellor Rachel Reeves' first budget promise. Addition of £22.6 billion in NHS day-to-day spending and £3.1 billion in capital spending over the following two years. The increase in day-to-day spending is geared toward meeting Labour's campaign promise of “40,000 more jobs” from its election manifesto.

This oft-repeated promise gives the federal government a concrete short-term goal in its long-term mission. 18 week target For optional maintenance. However, while 40,000 extra weekly hospital appointments may sound impressive, a more in-depth take a look at NHS statistics reveals that the rise is less important than it first appears.

NHS England makes almost 2 million outpatient appointments per week in 2023-24, meaning 40,000 more appointments per week would represent only a 2% increase.
In recent years, the common annual increase in weekly outpatient appointments has been 2.9%, meaning a further 40,000 appointments per week could be lower than the conventional increase.

The chart below shows the common variety of outpatient appointments per week for every financial 12 months from 2013-14, with the red point indicating a rise of 40,000 per week for 2024-25.

Average weekly outpatient appointments in NHS England, 2013-14 to 2023-24


Author's calculations from NHS outpatient activity data

While day-to-day NHS spending has promised the most important increase in funding, capital spending has increased. Out of proportion As it grows from a lower base (10.9% annual growth for capital expenditure, vs. 3.4% for day by day expenditure).

This promotion is a vital development, as some recent policy evaluation of the NHS emphasizes how Far back This is in capital expenditure. particularly, Organization for Economic Cooperation and Developmentwhich has members from 38 wealthy countries, noted that the UK has fewer diagnostic scanners, reminiscent of MRI machines, than other developed countries. It is because of this that the Chancellor has specifically earmarked a number of the recent capital expenditure for brand new assessment equipment.

His budget directs some recent capital funds to construct more community diagnostic centers (CDCs) and “surgical hubs” — two varieties of facilities which have sprung up lately. I'm a part of a research team at York University that has Analyzed the data On CDC performance. My partner and I too Working on a project To review the Surgical Hub program.

Both these kind of facility share common features. Their purpose is to mobilize staff, buildings and equipment for elective (planned) care, which is separate from the larger hospital spaces to take care of emergency patients.

Surgical hubs are facilities designed for elective surgery, reminiscent of hip substitute operations or cataract surgery. These hubs can either be a part of a Site of existing major hospital or a stand-alone facility, e.g Southwest Ambulatory Orthopedic Centerwas built on the positioning of a brand new hospital that was initially developed because the “Nightingale” hospital through the COVID pandemic.

Similarly, the CDC has separate facilities for routine (non-emergency) diagnostic tests and scans, reminiscent of those used to diagnose cancer or heart problems. They are designed to be positioned in additional convenient locations in the neighborhood away from major hospitals. Examples include Askham Bar CDC, positioned in a supermarket automobile park in York, and Wood Green CDC, positioned in a shopping mall in North London.

A man is about to enter an MRI scanner. A doctor stands aside.
The UK has fewer key diagnostic scanners, reminiscent of MRI machines, than other wealthy countries.
Mike Smith/Almy Stock Photo

Promising results

Initial evaluations of those recent facilities show promising results. Our A recent paper A review of the early stages of the CDC program found that the opening of the CDC increased the quantity of diagnostic tests in an area by 13 percent.

The Health Foundation (a health policy think tank) has published a Initial assessment of the Surgical Hub programme, which showed that hospital trusts implementing recent surgical hubs increased their surgery elective numbers by around 22%.

However, not one of the studies show an effect on reducing patient waiting times. This could also be since the policies are still of their nascent stages and it takes time for brand new facilities to scale back the backlog of patients.

However, it is usually possible that recent facilities Increased awareness and demand for care within the local population, keeping waiting times high.

Budget investment in increasing the efficiency of the NHS through higher day-to-day spending and more capital facilities is a welcome first step by the Government. Focus on investment is especially necessary, lacking lately.

However, the size of the NHS's challenges is vast, with growing demand quickly eating up any recent resources added to the system. In this environment, improving performance, reminiscent of waiting times, to the degrees seen under the previous Labor government is a distant prospect.