Patients face a postcode lottery of care when it comes to accessing the latest robot-assisted surgery on the NHS, a damning study reveals.
The Royal College of Surgeons says robotic surgery offers ‘real benefits’, such as faster recovery times, fewer complications and shorter hospital stays.
But its investigation found take-up of the new technology varies massively around the country, with 28 such systems in NHS trusts in London but just six across the South West.
There is no standard funding model for the equipment, so health bosses are forced to decide locally how to acquire it.
Some are using capital funding to buy the kit, which costs between £500,000 and £1.5million, while others are leasing it or even begging local residents for charitable donations.
The findings come despite the Government identifying robotics as one of five ‘big bets’ in its 10 Year Health Plan for England, with a vision that robots will help ‘deliver care with unprecedented precision’.
Medics conducted 70,000 robot-assisted procedures in the NHS in England in 2023/24 but this is expected to rise to half a million over the next decade.
Health officials say nine in ten of all keyhole surgeries will be delivered with robot assistance by 2035 – up from one in five at present.
A robotic surgical system pictured ahead of a state-of-the-art robot assisted surgery performed by the NHS at Solihull Surgical Hub in Solihull Hospital, West Midlands.
Health Secretary Wes Streeting, who had robot-assisted surgery when he had treatment for kidney cancer, has previously claimed such innovative technologies will ‘transform the NHS’.
But the new analysis suggests a ‘clear gap between national ambition and frontline reality’, the Royal College of Surgeons warns.
‘This reflects a broader lack of coordinated national planning, with decisions about robotic surgery often made locally rather than as part of a joined-up NHS strategy,’ it added.
The machines are capable of movements more precise than the human hand.
Experts say robotic surgery allows ‘greater dexterity’ and the tools are ‘easier to manipulate’ than in traditional surgery.
The range of robotic-assisted procedures has widened in recent years and spans multiple areas of medicine.
It typically sees surgeons control precision instruments using a console and a camera.
But in some orthopaedic procedures, robots are programmed to perform elements of procedures.
Tim Mitchell, president of the Royal College of Surgeons, said it is ‘extraordinary’ that some NHS hospitals are having to resort to local fundraising to pay for robotic systems.
The National Institute for Health and Care Excellence (Nice) approved 11 state-of-the art robots for use on the health service last year.
In some instances, robotic surgery can slash hospital stays by half.
The findings – the first publicly-available national picture of how surgical robots are being used across England – will be published today at the Future of Surgery Festival, in Birmingham.
College president Mr Tim Mitchell will tell delegates: ‘Robotic-assisted surgery can transform care and help reduce NHS waiting lists, but access remains a postcode lottery.
‘For one of the Government’s five “big bets”, it is extraordinary that some NHS hospitals are having to resort to local fundraising to raise vital funds.
‘It’s clear from this data that there is an urgent need for more grip on where robots are located and how they are funded, to ensure robotic-assisted benefits all patients, not just those in the right postcode.’
The College emphasises that not every hospital needs its own surgical robot but says all patients should have equitable access to hospitals and surgeons that provide robotic surgery.
It says there is no single, transparent national dataset on robotic surgery provision routinely or consistently available at a national level, making it difficult for NHS England, the Department of Health and Social Care and Integrated Care Boards to plan services strategically, assess equity of access and ensure value for money as robotic surgery expands.
Its investigation, based on responses to Freedom of Information requests, found Royal United Hospitals Bath NHS Foundation Trust spent more than £2 million in donations on robotic platforms.
The College wants the government to create a national public directory of surgical robotic systems; a clearer, more consistent funding model, including centralised capital funding, so trusts avoid relying on ‘piecemeal local or charitable funding’; and money to cover the cost of training.
It also says industry should make the machines more affordable, create flexible financial models so trusts have more opportunities to acquire machines and more support for refurbished models.
A Department of Health and Social Care spokesperson said: ‘Robotic surgery is making a huge difference in our NHS today, with these cutting-edge machines speeding up treatment, reducing recovery times and allowing patients to return to normal activities more quickly.
‘As set out in our 10 Year Health Plan, the NHS is committed to the adoption of robotic-assisted surgery for an expanded range of procedures. This is just one of the ways in which we will continue to drive forward the very best standard of care for patients.’
