As the NHS continues to grapple with long waiting lists and increasing demand, the government’s Elective Reform Plan has identified surgical hubs as a key solution. 14 new hubs are expected to open this summer within existing hospitals, with expansions to three more sites.
These purpose-built facilities aim to provide dedicated spaces for high volume, low complexity procedures, helping to reduce pressure on acute services and improve patient outcomes.
However, delivering these hubs effectively, at scale, on time and to the right standard, requires more than just ambition. It demands facilities that meet strict healthcare requirements and are delivered in ways that minimise disruption to already stretched hospital environments. Modern construction approaches, such as modular buildings, are playing an increasingly important role in achieving these aims.
Surgical hubs are designed to streamline elective procedures by operating independently from emergency services. This separation helps to protect elective care from being displaced during times of acute demand, such as winter surges or public health emergencies.
When planned and executed well, hubs can significantly improve patient flow, reduce cancellations and support faster access to treatment. They also enable clinical teams to work more efficiently by creating focused environments tailored to specific types of care.
However, creating such spaces, especially within active hospital sites, requires buildings that are not only fit for purpose but also meet the high standards expected in clinical environments.
When planned and executed well, hubs can significantly improve patient flow, reduce cancellations and support faster access to treatment
Compliance is critical for surgical hubs. In addition to detailed technical and clinical standards, such as HTMs, HBNs and CQC requirements, they need high levels of infection prevention, air quality regulation and safety. This includes positive or negative air pressure zones, HEPA filtration, wipe clean finishes and strict zoning between clinical and non-clinical areas to meet regulatory approval.
Adding in new clinical capacity within live hospitals is particularly complex, as Trusts must maintain ongoing patient care while also accommodating construction activity, presenting challenges around access, noise, dust and infection control.
One of the ways NHS infrastructure teams are managing this balance is by using modern methods of construction (MMC), including offsite and modular approaches. By allowing a significant amount of building work to take place in factory-controlled environments, the onsite construction window is reduced and disruption is limited.
A typical high-compliance surgical hub delivered using modern construction techniques, such as modular, can be brought from design to commissioning in approximately six to nine months. Due to overlapping phases of work, manufacturing of the modules can take place at the same time as site preparation and groundworks.
Crucially, MMC enables rapid delivery without affecting quality or safety. Compliance in healthcare infrastructure goes beyond infection control and ventilation. Fire safety, water management and emergency access are all governed by strict national guidelines.
For example, fire safety compliance in healthcare environments extends well beyond the selection of non-combustible materials. It encompasses the integration of engineered fire strategies that align with HTM guidance, including the design of compartmentation to restrict fire and smoke spread across clinically sensitive zones. This involves detailed coordination of fire-rated walls, ceilings, service penetrations and door sets all validated through passive fire protection assessments. For any new buildings, fire detection, alarm and suppression systems must be fully integrated with hospital-wide systems. Likewise, electrical compliance involves designing for resilience as well as reliability, meeting HTM 06-01 standards. In high dependency areas, this includes dual circuit resilience, uninterrupted power supply backup and emergency generator integration, each tested under simulated fault conditions.
Even the specification of surface finishes requires clinical and technical scrutiny
Ventilation systems must also meet HMT 01-01 standards, with laminar airflow systems in surgical zones and room pressure differentials carefully controlled to reduce the risk of airborne contamination. This is particularly critical in settings such as theatres, endoscopy suites and diagnostics areas, where air quality is essential for patient safety and regulatory sign off.
Even the specification of surface finishes requires clinical and technical scrutiny. Materials must be robust enough to withstand rigorous and frequent cleaning with high-level disinfectants, while also meeting infection control criteria for seamless installation.
Achieving this level of compliance within a compressed programme requires an integrated approach. Standards must be embedded in the design process from day one, which means engaging early with estates teams, clinical users, fire officers, infection control specialists and external regulators. It also requires rigorous quality assurance protocols, whether construction happens on site or in a factory-controlled environment. Inspections, testing and third-party certifications are essential at every stage, not just at handover.
Digital tools such as Building Information Modelling (BIM) and digital twins are increasingly being used to track compliance, simulate clinical workflows and predict building performance across the facility’s lifecycle. These technologies support both initial commissioning and long-term operational efficiency.
In this context, the faster pace of modern construction isn’t a shortcut, but an opportunity for better coordination, smarter planning and tighter control over compliance-critical processes. Whether built traditionally or offsite, surgical hubs must pass the same tests, meet the same clinical expectations and above all, provide patients with a safe, high-functioning space for their care.