Introduction of Hormone Therapy Injection Hubs (i-hub) for Prostate Cancer

Abstract

Prostate cancer is the most common cancer in men in the UK, with rising incidence placing increasing demand on hormone therapy delivery. Traditional Clinical Nurse Specialist-led injection clinics have become increasingly unsustainable due to growing referral numbers. This article describes the development and implementation of a dedicated injection hub (i-hub) for prostate cancer hormone therapy within an NHS Trust in the North of England, delivered in partnership with a pharmaceutical company and a healthcare service company (HSC). Service redesign was guided by Lewin's three-stage change management framework (Unfreeze, Change, Refreeze). The i-hub model introduced HSC nurses to deliver hormone injections and manage simple toxicities, freeing the CNS team to focus on complex assessment and counselling. Implementation involved governance review, staff training, joint stakeholder meetings and patient communication, with progress and patient satisfaction data monitored throughout. In the first 6 months, 178 new patients were seen, with a patient satisfaction rate exceeding 99%. The new model increased clinic capacity by 77%, from 704 to 1248 appointment slots annually, while remaining cost-neutral to the Trust. The prostate cancer i-hub demonstrates that nurse-led, partnership-based service redesign can increase capacity and improve patient experience while maintaining safety and cost neutrality. Success depended on strong governance, clear role definition and sustained communication across multiple stakeholders. Further research is needed to evaluate replicability across other NHS Trusts and to assess the operational, economic and workforce implications of wider adoption.