Mixed Methods EvAluation of the high-volume low-complexity Surgical hUb pRogrammE (MEASURE): a mixed methods study protocol

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INTRODUCTION: 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.

METHODS AND ANALYSIS: This 4-year project consists of 6 inter-linked work packages (WPs) and is informed by the Consolidated Framework for Implementation Research. WP1: Mapping current and future HVLC provision in England through document analysis, quantitative datasets (e.g., Hospital Episodes Statistics) and interviews with national service leaders. WP2: Exploring the effects of HVLC hubs on key performance outcomes, primarily the volume of low-complexity patients treated, using quasi-experimental methods. WP3: Exploring the impact and implementation of HVLC hubs on patients, health professionals and the local NHS through approximately nine longitudinal, multi-method qualitative case studies. WP4: Assessing productivity of HVLC surgical hubs using the Centre for Health Economics NHS productivity measure and Lord Carter’s operational productivity measure. WP5: Conducting a mixed-methods appraisal will assess the influence of HVLC surgical hubs on the workforce using: qualitative data (WP3) and quantitative data (e.g. NHS England’s workforce statistics and intelligence from WP2). WP6: 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 (PPI) will contribute to study design and materials.

ETHICS AND DISSEMINATION: The study has been approved by the East Midlands – Nottingham Research Ethics Committee 23/EM/0231. Dissemination plans include multiple academic and non-academic outputs (e.g. Peer-reviewed journals, conferences, social media) and a continuous, feedback-loop of findings to key stakeholders (e.g. NHS England) to influence policy development.

STUDY REGISTRATION: Researchregistry9364.
Original languageEnglish
Article numbere086338
Number of pages8
JournalBMJ Open
Publication statusPublished - 19 Apr 2024

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