NHS0001

 

Written evidence submitted by CMR Surgical

 

    1. CMR Surgical is a medical devices company headquartered in Cambridge that has developed a next-generation surgical robotic system. CMR Surgical is proud to work in partnership with NHS England to provide that robotic keyhole surgery, with the aim of providing better outcomes for patients, greater options for surgeons and value for healthcare providers.

 

    1. Robotic surgery is designed to enable surgeons to perform keyhole surgeries in a wide range of speciality procedures, including major gynaecological, thoracic, colorectal, and general surgeries including cancer. It is vital that patients are able to receive treatment as quickly as possible. However, waiting lists for elective care continue to grow, with hospitals carrying out 12% fewer operations and treatments than they were before the pandemic.[i]

 

    1. CMR Surgical welcomes the recognition from the Public Accounts Committee of the importance of tackling the elective care backlog and the support which the independent sector can provide. There remains a large unmet need in England for the delivery of cutting-edge surgical innovations. Investing in and embedding new technology in the NHS, including surgical robots, provides opportunities to reduce the elective care backlog.

 

    1. In the foreword of the Delivery plan for tackling the COVID-19 backlog of elective care, NHS England Chief Executive Amanda Pritchard pointed to the use of surgical robots in Milton Keynes hospitals to deliver more complex surgery with faster recovery times as an excellent local success story,[ii] underlining the role surgical robots can play in reducing the backlog.  

 

    1. Robotic surgery can support NHS backlogs and waiting times by:

 

5.1    Expediating operations by enabling complex surgeries to be undertaken through keyhole surgery. Manual keyhole surgery is physically demanding to perform precisely for surgeons;[iii] robotic surgery allows more patients to access keyhole surgery and therefore high-quality care.

 

5.2    Quickening recovery for patients. Real world evidence gathered from robotic assisted surgical procedures has shown that the use of surgical robots can reduce patient length of stay following operations and therefore free up NHS bed space. Data from Milton Keynes University Hospital shows that 450 bed days are saved per year.[iv]

 

5.3    Reducing likelihood of re-admission. Performing surgery by keyhole results in less pain and scarring for patients, and a reduced risk of complications, making it less likely that they will need to return to surgery. Research shows that 52% of patients who had open colorectal surgery were readmitted to hospital, compared to 0.2% who had minimally invasive surgery.[v]

 

5.4    Supporting the surgical workforce. Surgical robotic technology reduces the physical strain on surgeons, supporting their physical and mental health at a crucial time and potentially extending the peak age for surgeons to continue their work.[vi] This is hugely important given workforce pressures in the NHS which contribute to the lengthening backlog, and high levels of burnout amongst healthcare professionals.

 

    1. However, the benefits of surgical robotics are not felt consistently across England. Not all patients have access to robotic surgery; access depends on whether a hospital trust has invested in a surgical robot, which creates an inequitable system where some patients are given a higher quality of care than others.

 

    1. Greater utilisation of surgical robotics in the implementation of national elective recovery plans through national guidance would create more consistency in uptake. In NHS England’s elective recovery plan, surgical robotics are only referenced in the foreword, not as part of the plan itself; commitments to increasing surgical capacity and the rollout of new surgical hubs are not supported by specific commitments for robotics.[vii]

 

7.1               Greater and more consistent utilisation of surgical robotics could be achieved through a national robotics strategy for England. This approach is already being employed in Wales through the All-Wales Robotic Assisted Surgery Network, which is expected to deliver an annual baseline of 800 cases to support the reduction in the elective care backlog.[viii]

 

    1. Surgical robotics are already delivering significant benefits for patients, surgeons, and the NHS when it comes to elective care. A national approach to the rollout of robotic technology is required to deliver these benefits more widely and more rapidly. NHS England has the potential to become a world leader by investing in innovation.

 


[i] BBC News. Fewer ops being done as NHS waiting list hits seven million [Internet]. 2022 October [cited 2022 November]. Available from: https://www.bbc.co.uk/news/health-63219147

[ii] NHS England. Delivery plan for tackling the COVID-19 backlog of elective care [Internet]. 2022 February [cited 2022 November]. Available from: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2022/02/C1466-delivery-plan-for-tackling-the-covid-19-backlog-of-elective-care.pdf

[iii] CMR Surgical. Surgical strain: ergonomics in surgery [Internet]. 2019 September [cited 2022 November]. Available from: https://cmrsurgical.com/news/one-in-five-surgeons-set-to-retire-early-due-to-physical-toll

[iv] CMR Surgical. Milton Keynes University Hospital saves 450 bed-days annually following adoption of Versius [Internet]. 2022 March [cited 2022 November]. Available from: https://cmrsurgical.com/news/cmr-surgical-MKUH-case-study

[v] Dobson MW, Geisler D, Fazio V, Remzi F, Hull T, Vogel, J. Minimally invasive surgical wound infections: laparoscopic surgery decreases morbidity of surgical site infections and decreases the cost of wound care [Internet]. 2011 July [cited 2022 November]; Colorectal Dis. 13(7):811-5. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1463-1318.2010.02302.x

[vi] CMR Surgical. Surgical strain: ergonomics in surgery [Internet]. 2019 September [cited 2022 November]. Available from: https://cmrsurgical.com/news/one-in-five-surgeons-set-to-retire-early-due-to-physical-toll

[vii] NHS England. Delivery plan for tackling the COVID-19 backlog of elective care [Internet]. 2022 February [cited 2022 November]. Available from: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2022/02/C1466-delivery-plan-for-tackling-the-covid-19-backlog-of-elective-care.pdf

[viii] Cardiff & Vale University Health Board. Robotic Assisted Surgery – Business Case Nov 2021 [Microsoft Word]. 2021 November [cited 2022 November]. Available from: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiY4JKoo4n4AhVTfMAKHQ9RDeYQFnoECAsQAQ&url=https%3A%2F%2Fcavuhb.nhs.wales%2Ffiles%2Fboard-and-committees%2Fboard-2021-22%2F6-4a-robotic-assisted-surgery-business-case-nov-2021-docx%2F&usg=AOvVaw0HUKRELhGo2cLQe9ZbWeJO

 

November 2022