Wales is the first country in the world to introduce multiple Versius® Surgical Robotic Systems as part of a national surgical robotics programme. With hundreds of patients initially expected to benefit from the programme annually, this landmark move offers a clear model for implementation of a national strategy.
Today, hospitals are looking to technologies to address demands on the healthcare system, reduce costs of healthcare, improve quality of care and protect their workforce. This is especially true in the surgical field where surgical backlogs and pandemic recovery continue to plague health systems and surgical teams. In my role as General Manager, UK and Ireland at CMR Surgical, I see first-hand that the pressure on hospitals is enormous.
In response to record waiting lists, a struggling surgical workforce and a strong desire to improve outcomes for cancer patients, the Welsh government introduced a national robotics assisted surgery strategy in March 2022 through the All-Wales Robotic Assisted Surgery Network.1 At CMR Surgical, we are proud to be the preferred industry supplier in this pioneering strategy, and we welcome the leadership that Wales has shown in adopting this approach that will deliver real benefits for the NHS, surgeons, and most importantly, patients.
Prioritising improved patient outcomes across an entire system is a key rationale for this national strategy in Wales. The programme identified robotic assisted surgery as one of the key technologies that will deliver the greatest positive impact for patients.2 This was in response to a 2019 report from the Royal College of Surgeons, where at the time, 74 surgeons had performed 374 robotic assisted colorectal cancer surgery procedures in England, while no colorectal procedures had been undertaken with surgical robotics in Wales. Prior to the pandemic, cancer incidence rates in Wales were already increasing, with some regions rising higher than UK averages. At the same time, while the pandemic was unfolding, it was clear that a national strategy was needed to address the surgery backlogs, support the NHS workforce and further develop research capacity and improve data collection.
To address these concerns, the All-Wales Strategy that was devised included provision for; Welsh government funding for the strategy, with additional funding provided by local health boards over 10 years; a network supported by CMR Surgical to deliver the strategy; and a collaborative training network for surgeons to futureproof the workforce against growing instability while closing skill gaps in locations and surgeon demographics, in order to provide an equitable service.
Given the world first nature and infancy of this programme, the learnings and value of a nationwide strategy will still be determined. However, in both the short and long term, such a development highlights the potential strength of country-wide public health programmes, as health systems around the world face rising pressures and growing backlogs of elective care while we recover from the pandemic.
What is clear is that surgical robots offer the opportunity to transform the delivery of surgery, where there remains a large unmet need to deliver meaningful innovation to hospitals, in line with the goals of the government’s Life Sciences Vision. However, concrete actions need to be taken in order to realise the potential of robotic surgery for patient outcomes and service delivery, including:
- A national strategy and pathway for the adoption (and funding) of robotic surgery
- Fast-tracked procurement of robotic systems within the NHS, guided by the national strategy
- Support the collection and analysis of real-world evidence, for the efficient ongoing evaluation of clinical and economic value of surgical robots to improve care for patients
Insights from Wales’ leadership from this programme could provide lessons for other UK nations and countries considering a similar approach. In line with experiences in Wales, and a recent Association of British HealthTech Industries white paper,3 the question therefore remains, where are other nations in establishing their own clear national strategies for the implementation of surgical robotics?
1 Welsh Government. National robotic assisted surgery programme to be established in Wales [Internet]. 2022 March [cited 2022 June]. Available from; https://gov.wales/national-robotic-assisted-surgery-programme-be-established-wales
2 Cardiff & Vale University Health Board. National robotics-assisted surgery programme – Business case. Cardiff: The Board; 2021
3 Association of British HealthTech Industries Ltd. ABHI White Paper: Robotic-Assisted-Surgery and New Models of Surgical Care. February 2022. Available from: https://www.abhi.org.uk/media/3450/ras-white-paper.pdf