So, what’s the solution? Since the 2018 white paper No hospital is an island, important strides have been made in acute care collaboration through the adoption of group models and chains in the NHS. However, the tangible benefits of these can be slow to mobilise, even with significant investment in rebuilding culture, governance and operational processes. Elective Care Hubs enable trusts to deliver benefits at pace but with less upfront investment required. By combining resources to deliver elective activity within a health system or geography, the utilisation of resources such as theatre space, bed capacity, equipment and staffing can be maximised, as can the ability to treat patients in date or priority order.