Comment EDITOR’S COMMENTwith LOUISE FRAMPTON THE CLINICAL SERVICES JOURNAL


OPERATING THEATRES


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Louise Frampton louiseframpton@stepcomms.com Technical Editor Kate Woodhead Journal Administration


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Tackling the backlog and the need to invest in modern theatres


Once again, CSJ’s annual Operating Theatre Supplement is packed with educational articles on technology innovation, patient safety, infection prevention, advances in surgical techniques, sustainability, efficiency, the backlog recovery, emerging trends, and workforce planning. We know that surgery is becoming more precise, as we use a greater degree of


technology and robotic systems, but we are also seeing exciting developments rapidly unfold in the field of artificial intelligence. While AI and smart technologies have the potential to drive improvement in efficiency and outcomes, it is important that we keep in mind the vital role that humans must have as “guardians” of the technology. In this edition, we report on the insights of Dr. Ankur Mukherjee, a Consultant Urological and Robotic Surgeon, who recently spoke at The Møller Institute, University of Cambridge, as part of AfPP’s regional conference programme. He pointed out that theatre efficiency is not just about speed – it’s about reliability, safe care and self-care. AI can integrate effectively into the surgical pathway – pre-operatively, perioperatively and post-operatively – to support theatre efficiency, but it is “still very much a human endeavour,” he commented. Digital technology and robotic systems can help to tackle the backlog, but it is also important to get the basics right around theatre infrastructure and investment in staff. NHS waiting lists have risen once again and the Royal College of Surgeons of England (RCS England) has said the figures make clear just how fragile recent progress is. Surgeons across England continue to report significant barriers to treating patients on


time, including ageing hospital buildings, limited operating theatre capacity, and ongoing shortages of beds and staff. RCS England’s most recent workforce census found that restricted access to theatres remains one of the biggest constraints on surgical activity. The latest NHS consultant led referral to treatment (RTT) waiting times data for April 2026


show that 65.0% of patients started treatment within 18 weeks. The overall waiting list has increased to 7.2 million. In April 2026, 99,781 people had been waiting longer than one year for treatment. The NHS missed the target to reduce the proportion of people waiting over 52 weeks for treatment to less than 1% of the total waiting list by March 2026. Commenting on the figures, Professor Frank Smith, Vice President of RCS England, said:


ISSN No. 1478-5641


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“Reforms to the way care is delivered are beginning to make a difference, but they can only go so far. Clearing the backlog and meeting the 2029 target will require a step change in surgical capacity, backed by significant capital investment.” Theatre teams have been working extraordinarily hard to bring down waiting lists,


and technologies such as AI and robotics have the potential to contribute to improved efficiencies. But we also know that our basic infrastructure requires urgent replacement and upgrading. Hospitals have experienced repeated issues with maintenance in operating theatres leading to unnecessary cancellations of operations and theatre closures. In one highly publicised case, a power outage during a spinal surgery procedure required staff to use mobile phone torches to complete wound closure. This state of affairs is not only unsafe, but further exacerbates the backlog. I desperately hope that we will be celebrating a seismic shift in tackling waiting times, when I come to write my comment for next year’s Operating Theatre Supplement. “We have done it before and we can do it again,” Labour has promised. The next PM needs to back this with investment and deliver on the New Hospital Programme, ensuring the basics are in place – i.e. safe, fit-for-purpose surgical environments. With recent talk of moving NHS budgets to fund increased spending on defence, all eyes will be on how the Government will tackle the problem of ageing NHS infrastructure and how potential cuts to NHS budgets may impact the theatres of the future. Robbing Peter to pay Paul certainly won’t help the NHS achieve further progress on reducing the backlog.


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