Despite the train strike cancelling our Operational Delivery Network (ODN) meeting on November 7th 2022, the Thames ODN teams hosted a scaled down meeting at the esteemed Royal College of Surgeons of England, in London. Operational Delivery Network members from East Midlands, Northwest, North Thames, Southwest, South Thames and the West Midlands discussed the achievements of each ODN. This highlighted the hard work being done to improve collaboration within the area, but also on individual pieces of work focusing on how to improve the surgical patients care pathway. We identified that we had a lot in common and we are all aiming for a high level of performance. The EMSiC Team are looking forward to meeting the rest of the ODNs in the New Year for a face-to-face National ODN meeting.