Robot-assisted surgery
Surgical robotics and the elective surgery backlog
Miss Tamsyn Grey, Consultant Colorectal and General Surgeon, Clinical Lead for Robotic Surgery, Calderdale and Huddersfield NHS Foundation Trust, gives a surgeon’s perspective on the contribution that robotic-assisted surgery can have in tackling the backlog.
In the wake of the COVID-19 pandemic, the NHS has found itself navigating an unprecedented elective care backlog. At its peak in September 2023, the elective waiting list in England exceeded 7.8 million patients, the highest on record.1
For Calderdale and Huddersfield NHS
Foundation Trust (CHFT), the pressure to deliver safe, efficient surgical care while meeting rising demand echoed the challenges faced in the rest of the country. Amidst this challenge, however, we’ve seen cause for cautious optimism. By combining new technologies with pragmatic service redesign and focused workforce development, CHFT has seen tangible progress on backlogs. Since the introduction of robotic-assisted surgery in 2023, CHFT has achieved a 30% reduction in its elective backlog. While this success is the result of a broad series of initiatives, data suggests the integration of surgical robotics is an important factor contributing to this progress. As Clinical Lead for Robotic Surgery and a Consultant Colorectal Surgeon at CHFT, I’ve
observed how a thoughtfully implemented robotic programme, rooted in multidisciplinary buy-in and supported by internal training and mentorship, can enhance surgical practice, support teams and ultimately improve access to care for patients.
A local Trust facing national challenges Colorectal surgery in a District General Hospital (DGH) setting comes with a unique set of pressures. Many of our patients are older, multi-morbid, and live with long-term conditions, which can worsen while waiting for surgery. Others are facing urgent cancer diagnoses that demand timely, safe surgical intervention. At CHFT, we serve a population of
approximately 465,000 people across West Yorkshire. Historically, we’ve shared the same challenges as many Trusts: staff shortages, rising patient complexity, and delays linked to COVID-era backlogs. Prior to 2023, colorectal cancer resections were performed
laparoscopically or, for more complex cases, via open surgery – both of which carry important limitations for patients and surgeons. When the Trust began exploring a robotic
programme, our aim was to implement a strategic approach that could improve the availability of minimally invasive surgery (MIS) across multiple specialties, improving outcomes and helping the Trust keep pace with rising demand. Our data suggests that robotic- assisted surgery, when properly implemented, can help support wider system resilience.
Starting a multi-specialty robotics programme I joined CHFT as a consultant colorectal surgeon in 2015 and in 2022 became interested in developing a robotic surgical programme at the Trust. This was largely inspired by the realisation that an established robotic programme would entice future consultants, rather than a desire to move away from being a laparoscopic surgeon. That year, with support from our general manager, we began planning for a multi-specialty robotics programme. From the outset, we established a clear
directive that robotics should not be limited to one department and should be embedded broadly into colorectal, urology, and gynaecology services. The programme launched in June 2023, beginning with colorectal surgery but then quickly expanding into the other specialties. Currently, robotic surgery is conducted on
average four days a week in CHFT’s theatres. Two of those days are consistently allocated to colorectal cases, while the remaining lists alternate between urology and gynaecology, based on clinical need. We maximise utilisation within the programme through our team stepping in when other specialties don’t have a need for the system. The decision to build a multi-specialty
programme was essential. Not only does this allow the Trust to maximise return on
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