Comment EDITOR’S COMMENT with LOUISE FRAMPTON THE CLINICAL SERVICES JOURNAL
OPERATING THEATRES
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Louise Frampton
louiseframpton@stepcomms.com
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STEP COMMUNICATIONS ISSN No. 1478-5641
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Tackling the backlog: what’s next?
A lot has changed in the past year, since the last publication of the Operating Theatre Supplement. We now have a new Government, robotic surgery continues to advance at pace, artificial intelligence is gaining ground, and we now have a 10-year plan for the NHS. We have also seen the success of initiatives such as ‘HIT lists’ and ‘Super Saturdays’. However, some things have remained unchanged – including long waiting lists for
surgery, constrained NHS finances, crumbling estate, workforce shortages, dissatisfaction over pay, and reports of burnout among surgical teams. These issues will take time to fix, and require significant investment. Nevertheless, there are initiatives that could help drive improvement. The Government has pledged to increase the number of surgical hubs, which will help protect planned care from the impact of seasonal and other pressures. The British Association of Day Surgery (BADS) also points out that expanding day surgery is key to elective recovery and has clear benefits for patients, staff and services. Recent data shows that 83.9% of surgical procedures in the BADS Directory of Procedures within England are being undertaken as day cases or outpatient procedures – just shy of the 85% expectation, with large variation between providers. There is room for improvement by tackling variation across NHS Trusts and this edition looks at some of the reasons why this is important going forward. The private sector has increasingly been used to tackle the backlog, and the government
wants the private sector to deliver an additional one million appointments a year for NHS patients. Mr Tim Mitchell, President of the Royal College of Surgeons of England (RCS England) commented that, given the current long waiting lists for patients, it is “right to use independent sector capacity to deliver more treatments”. However, he added that it is not a long-term solution: “We need to expand the NHS’ permanent capacity and address its ageing estate without delay,” said Mr Mitchell. “In this context, it is disappointing that capital funding for the NHS will remain flat in real terms for the next three years.” He further called on the government to improve investment in NHS estates and IT. Otherwise, surgeons will “continue to work in outdated theatres and crumbling buildings that hamper their ability daily to get on with the job of treating patients.” “You can’t deliver 21st century care in 20th century facilities,” he added. RCS England also said that a £120 million package of funding announced by the Welsh
Health Secretary, Jeremy Miles, will go some way in helping reduce long waits for planned care. However, it warned that the scale of waiting lists requires a longer-term strategy, with increased investment in surgical hubs. Scottish Ministers have also pledged a 50% increase in surgical procedures. Innovation
will be key to delivering on this ambition, according to Graham Watson, Executive Chair of InnoScot Health: “There are many ways in which patient outcomes can now be improved, particularly with a growing array of technologies which can be increasingly deployed – from AI for improved screening and virtual hospital wards to software which supports more efficient utilisation of existing operating theatres.” NHS entrepreneurs must be supported, as they could have a vital contribution, going forward. Ultimately, investment in technology will be key to recovery. Sir Jim Mackey, NHS Chief Executive, said: “The NHS has pledged to return to shorter elective waiting times by 2029, and we are using every tool at our disposal to ensure patients get the best possible treatment. Expanding the use of new and exciting tech such as robotic surgery will play a huge part in this.”
In short, reducing the backlog will require a multi-faceted approach. There have been some impressive efforts from surgical teams across the UK. But there is much more we can do – with the right investment, the right strategy, and the right technology.
louiseframpton@stepcomms.com Get in touch and give us your views, email me:
July 2025 I
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