Operating theatres
improved collaboration among surgical teams; while hybrid operating rooms, which utilise CT, MR, or C-arm imaging to perform complex operations, supplementary to conventional surgeries, represents a significant opportunity for the future. There is much to be excited by. However, the workforce must be considered
vital to implementing and overseeing the necessary changes as NHS Scotland becomes more technologically driven. Furthermore, the introduction of new tech is not always required for an operating theatre to become digitally ‘smarter’, while producing significant improvements. NHS Tayside’s ophthalmology service
was able to double the number of cataract surgical procedures that could be carried out daily, thanks to groundbreaking ideation. The improvements by the ophthalmology team at Ninewells Hospital in Dundee included the ability to carry out simultaneous bilateral surgery on patients with cataracts in both eyes. The team also sped up its theatre model by
introducing a double nursing team working on a ‘tag team’ basis to support the surgeon, in turn cutting down time in between patients and allowing the completion of between 24 to 32 procedures in a single day. Collectively, this turned Tayside into the best performing health board in Scotland for cataract surgery. Similarly, orthopaedic specialists at the Golden Jubilee University National Hospital revealed an innovative model for joint replacement surgeries by utilising a solitary consultant in a dual theatre setup, potentially cutting waiting times and lowering costs. Trialled in theatres at the Golden Jubilee University National Hospital in Clydebank, the high-volume system saw patients being readied for surgery in a second theatre while the first operation was still underway. Orthopaedic Consultant, Herv Vidakovic said
that both theatre lists were carefully planned out to ensure only patients who were safe and appropriate for the trial model were involved, with timings calculated precisely to ensure he was present from start to finish in all cases. Aside from reduced costs and no additional
theatre staff being required – unlike a traditional list – the model could overcome incidences of staff absence in future thanks to a single consultant being potentially able to cover two lists in the same day. The career progression of
trainee orthopaedic surgeons also benefitted from the trial after they took a lead in half of the cases, under the supervision of senior consultants to ensure patient safety. Christopher Gee, Consultant Orthopaedic
Surgeon and Associate Medical Director for National Elective Services at the Golden Jubilee University National Hospital, said: “While at the moment this isn’t something we could do on a daily basis, this trial has shown that we have the team and skills required to maximise theatre utilisation in a way that is cost-effective and continues to support the training of tomorrow’s surgeons.” While reducing waiting lists and making NHS
Scotland more efficient are the primary drivers behind much of the technological innovation being introduced across our NHS, the ambitious Net Zero 2040 target is also encouraging positive progress in making operating theatres more environmentally efficient. Staff at NHS Forth Valley recently told of their
efforts to optimise high carbon theatre facilities, including adjusting the speed of fans within Heating, Ventilation, and Air Conditioning (HVAC) systems, while evaluating the effectiveness of anaesthetic gas scavenging systems. Another particular area of success for NHS Scotland has been the targeted reduction of medical gas emissions, including widespread replacement of high carbon anaesthetic gas Desflurane with a less harmful gas – a first for UK national health services. On top of that, Scotland’s National Green Theatre Programme has supported health boards to achieve annual reductions of around 20,000 tonnes of carbon dioxide generated from surgery, in turn creating financial savings of around £6 million. The programme advocates the introduction
of actions which will not only reduce the environmental impact of theatres but also improve both the patient and staff experience. It further encourages collaborative initiatives for enhanced innovation opportunities, including reductions in energy use or waste, changes in clinical practice, or identification of a device, instrument or piece of equipment that could make less environmental impact. The Green Theatres team is also aiming to set up trials of reusable gowns with just one traditional gown estimated to be equal in waste to 70 single use gowns. Forward-thinking, green- minded staff at the Golden Jubilee also recently
We have seen a surge of exciting breakthroughs taking place in recent times across NHS Scotland, many of them spearheaded by the workforce’s forward-thinkers.
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www.clinicalservicesjournal.com I April 2025
helped to co-design biodegradable, reusable theatre caps – part of a research project led by the University of Strathclyde and Heriot-Watt University.
With 800,000 single-use theatre cap products disposed of annually by Scottish hospitals, the potential for further rollout across Scotland is of course exciting. Smart operating theatres are undoubtedly a work-in-progress, both in Scotland and across the world, but the technology, workforce insight, and thirst is already there. Based on progress to date, and the shared ambition to use technology to shape a more efficient, environmentally focused, and modern NHS, innovative solutions are ripe for development and adoption.
CSJ
About the author
Graham Watson is the Executive Chair of InnoScot Health, which works in partnership with NHS Scotland to identify, protect, develop and commercialise healthcare innovations to improve patient care. Formed in 2002, formerly known as Scottish Health Innovations Ltd (SHIL), InnoScot Health is a private company registered in Scotland (SC236303) and limited by guarantee with three shareholders – Scottish Ministers through the chief scientist office, NHS Tayside and the Golden Jubilee University National Hospital. InnoScot Health’s multidisciplinary team uses specialised knowledge to help bring new ideas and innovations from healthcare professionals to life. The organisation provides expert services including intellectual property advice and protection, regulatory expertise, project management, idea incubation, funding advice, development and commercialisation, and post-commercialisation monitoring. InnoScot Health supports collaboration across the Scottish healthcare innovation ecosystem and works to ensure NHS Scotland provides the right environment to support innovation with an empowered workforce continually driving improvements in the quality and value of patient care. Visit:
www.innoscot.com
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