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Telegraph
2 days ago
- Health
- Telegraph
Robots to perform surgery to cut NHS waiting times
Robotic surgery will be used en masse to cut NHS waiting times. On Wednesday, the head of the NHS will pledge a major expansion of robotic surgery to cover half a million procedures a year within a decade. Wes Streeting, the Health Secretary, said his life had been saved with the help of robots as he backed plans to use technology to boost productivity and cut waiting lists. The technique can be much more precise than the human hand, allowing greater dexterity as surgeons manipulate instruments using a 3D camera. Surgeons can get through operations more quickly, clearing waiting lists, and hospital stays will be halved because procedures are less invasive and cause less tissue damage. As a result, it can cut costs, help with a shortage of medics and get patients back to work more quickly. Robots will become the 'default' option for keyhole surgery, and be rolled out in many other cases, including hip operations and emergency procedures. Sir Jim Mackey, the NHS chief executive, will tell a conference of NHS leaders on Wednesday: '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. 'Not only does it speed up the number of procedures the NHS can do, but it also means better outcomes, a faster recovery and shorter hospital stays for patients.' Hospital stays halved The plans will mean around two-and-a-half to three million operations are delivered using robotic techniques in the next decade, bringing the total to half a million a year by 2035, up from 70,000 operations in 2023/24. Nine in 10 of all keyhole surgeries, such as the removal of organs affected by cancer, will be delivered with robot assistance within the next 10 years – up from one in five today. The NHS also expects to use the technology for increasing numbers of emergency operations. The rollout of the approach has halved hospital stays for some bladder cancer patients, bringing it down to just five days. Some experts believe that it can save more than £1,000 per patient. Transforming the NHS When robotic surgery was first introduced, the focus was largely on urological cancer surgery, but in recent years it has been introduced to several more areas, including bowel, gynaecology, ENT and orthopaedic procedures. It means operations like hysterectomies, which could involve a stay of up to a week, have reduced time in hospital to just 24 hours. The new forecasts, announced at NHS ConfedExpo in Manchester, follows national guidance on how robotic programmes should be delivered. Mr Streeting said: ' Innovative treatments and technologies that help fast track better outcomes for patients is how we transform our NHS and make it fit for the future. I know, myself, how important this is, when the NHS saved my life from kidney cancer with an operation led by a world-class surgeon being helped by a robot.' He said the moves would 'help cut waiting lists and get patients treated on time again'. Speaking ahead of the comprehensive spending review, which is expected to boost NHS funding by £30 billion a year by the next election, the Health Secretary said: 'We have put a record £26 billion into our NHS and social care, which includes cash to bring more cutting-edge tech into the health service to boost productivity, speed up recovery rates, and get people back to their best as soon as possible.' John McGrath, consultant surgeon at North Bristol NHS Trust, and chair of the NHS England Robotically-assisted Surgery steering committee, said: 'Robot-assisted surgery is a perfect example of innovation improving patients' care and transforming the way the NHS works – the number of procedures being carried is set to rapidly grow over the next 10 years according to our analysis. 'Robot-assisted surgery can also make complex operations less physically demanding for surgeons, with the potential to reduce strain on surgical teams, allowing a greater number of complex surgeries to be carried out each day.' Last year, patients at Liverpool University Hospitals NHS Foundation Trust became the first in Europe to be offered robotic-assisted surgery for head and neck cancers. Treating throat cancer Robotic assistance enables surgeons to access tumours through a single incision or natural orifice, such as through the mouth, with surgical instruments that can then work more easily in the tight space of the throat and airway. It means surgeons at Aintree University Hospital can remove tumours of the throat that previously would not have been accessible through the mouth. In some cases where tumours were unable to be removed through the mouth, without the use of robotic assistance, patients would have needed big operations to split their jaw to reach the cancer. This causes a lot of pain, a complicated hospital stay for up to two or three weeks with feeding tubes, and usually requires a tracheostomy tube for a period, to ensure patients can breathe safely. Matthew Taylor, chief executive of the NHS Confederation, said the expansion could bring 'significant efficiency gains' and improve outcomes for patients. However, he said: 'To achieve these productivity boosts requires the upfront investment in robotic surgery technologies, which can often be very expensive. This is why it is so important for the Government to continue to increase capital investment into the health service to make up for decades of underinvestment.' Kate Seymour, head of external affairs at Macmillan Cancer Support, said: 'We know that many people living with cancer across the country are facing long delays for care, and it's exciting developments, like those in robotic surgery announced today, that form an essential piece of the puzzle for sparking a much-needed revolution in cancer care.'
Telegraph
15-05-2025
- Health
- Telegraph
Labour to hand NHS bosses £30k bonuses to cut waiting lists
Labour will hand NHS bosses £30,000 bonuses to cut waiting lists under new plans. The financial incentives will see hospital chief executives earn an extra 10 per cent on top of their six-figure salaries for reducing waiting lists and managing budgets. At least 10 of the around 215 NHS trust leaders in England earned more than £300,000 in 2023-24, raising the prospect that the scheme will cost millions of pounds. The plans will also see failing trust leaders forgo annual pay rises, while those who move to the worst-performing hospital trusts will land themselves uplifts of 15 per cent worth around £45,000 for up to two years. Writing in The Telegraph, Wes Streeting, the Health Secretary, said the bonuses were for leaders who 'deliver exceptional results'. He said those who turn failure around 'deserve recognition' after being inspired to drive improvements like the 'best businesses in the world'. Of failing NHS bosses, he said some had 'pocketed massive salaries whilst letting services crumble' and 'deserve the consequences'. Mr Streeting added: 'This government won't accept failure as inevitable. Not when it means someone's mum waiting 12 hours on a trolley. Someone's dad missing his cancer treatment. Or someone's child stuck on a waiting list... 'This is about a rising tide lifting all ships. Better leaders create better teams and better care. By rewarding excellence, we'll transform NHS culture from top to bottom.' Bonus plan 'hard to justify' Edward Argar, the Conservative shadow health secretary, said the bosses were 'being handed generous rewards for meeting targets they were already expected to deliver'. 'At a time when families are being squeezed by Labour's reckless and irresponsible jobs tax and Winter Fuel Payments being snatched from vulnerable pensioners, it's hard to justify funnelling public money into bonus pots for senior managers, rather than front-line care,' he said. The NHS waiting list fell for a sixth month in a row in February, dropping to 7.4 million. But Sir Keir Starmer, the Prime Minister, has promised to meet a target of 92 per cent of NHS patients being seen within 18 weeks of a referral by 2029. The new framework for trust chief executives is set to be finalised in July. Under the plans, bosses will be ranked into one of five tiers depending on their performance. It is not yet clear how the success of NHS bosses will be measured but bonuses will be up to the discretion of a 'local remuneration committee'. The draft framework, seen by The Telegraph, says 'exceptional contribution' leading to a bonus could include 'leading a significant reduction to the provider's deficit or moving the organisation out of its challenged status'. A similar initiative was rolled out by Tony Blair's Labour government. Hospital bosses were ranked in categories from A to D based on performance criteria such as hitting waiting-time targets, cutting MRSA infection rates and financial management. A-rated managers were awarded a pay rise and performance bonus while D-rated managers did not get either, with budget management judged to be most crucial. David Cameron, the former Conservative Prime Minister, ended the bonuses for NHS managers and senior civil servants upon taking office in 2010. He vowed to 'lead from the front' and tackle 'the country's record budget deficit'. Sir Jim Mackey, the chief executive of NHS England, said linking pay to operational performance happened in 'almost every other sector' and that strengthening this was 'an important element of driving improvements'. He said: 'There is no reason for the NHS to shy away from it, particularly when we rely on money that comes directly from taxpayers' pockets. 'We will be working together with local leaders to improve transparency and ensure progress is recognised, while offering sufficient flexibility to attract talented candidates to the most challenging roles and organisations.' However, some critics have queried how performance can be accurately measured by politicians given the NHS does not run like a typical business. Dr Kristian Niemietz, editorial director and head of political economy at the Institute of Economic Affairs think tank, said there was 'nothing wrong with the principle' but the problem was 'what counts as 'good performance' is decided by politicians, not patients'. He added: 'There is, in reality, no objective metric for overall performance. If a healthcare provider cuts their waiting times, but if this comes at the expense of clinical outcomes or patient experience – is that an improvement or not? 'In the private sector, but also in more market-based healthcare systems, it is in every provider's own best interest to work out what their customers want, and how best to deliver that. This simple but effective mechanism cannot be replaced by politically determined performance schemes.' Sean Phillips, head of health at the Policy Exchange think tank, welcomed the 'focus on attracting top talent to the most challenged NHS organisations' but warned that 'bonuses should be awarded for exceptional performance – not for balancing the books'. He added: 'Moreover, reforms to performance management are required throughout NHS management – not just for very senior managers and CEOs.' The new framework will also see pay bands for senior managers overhauled to attract and retain staff. Last November, Mr Streeting pledged to sack failing NHS managers. The Government has also proposed other incentives to tackle NHS waiting lists, including bonuses for hospitals that 'validate' their waiting list and remove patients who no longer need to be seen. Concern over 'needless deaths' in A&E Meanwhile, the Royal College of Emergency Medicine (RCEM) has claimed that 'the equivalent of two aeroplanes' of people have been dying 'needlessly in A&E every week'. It estimated there were more than 16,600 deaths of patients linked to long waits for a bed, an increase of a fifth on 2023 and the equivalent of 320 a week. Dr Adrian Boyle, the RCEM's president, said: 'I am at a loss as how to adequately describe the scale of this figure. To give it some context, it is the equivalent of two aeroplanes crashing every week. 'It's sobering, heartbreaking, devastating and more. Because this is so much more than just data and statistics.' He added: 'Each number represents a person – a dearly loved family member, grandparents, parents, siblings and friends – who has died because of a system in crisis. 'These were patients who were stuck in emergency departments, watching the clock tick by as they waited extremely long hours, often on a trolley in a corridor, for an in-patient bed to become available for them.' No rewards for failure, but plenty for success By Wes Streeting, Health Secretary When I became Health Secretary, I promised to be straight with Telegraph readers about the challenges facing our NHS. We inherited waiting lists at record highs. Patients stranded for hours waiting for ambulances. Hard-working staff pushed to the brink. The system wasn't just broken – it was on life support. Behind hospital doors, managers make decisions every day that affect your care. Many do an incredible job in impossible circumstances. But others have pocketed massive salaries whilst letting services crumble. The NHS isn't a normal workplace. When things go wrong, people suffer. Patients wait in pain. Operations get cancelled. Lives hang in the balance. This government won't accept failure as inevitable. Not when it means someone's mum waiting 12 hours on a trolley. Someone's dad missing his cancer treatment. Or someone's child stuck on a waiting list. The leaders who can turn these situations around deserve recognition. Those who make excuses deserve consequences. This is about a rising tide lifting all ships. Better leaders create better teams and better care. By rewarding excellence, we'll transform NHS culture from top to bottom. When bosses deliver, everyone wins – staff morale soars, patient care improves, and waiting lists shrink. I promised no more rewards for failure – and today we are making that happen. Driving better care Under new rules published today, NHS bosses who waste money or let patients down will have annual pay rises docked. It means that, if the proposals were in place for last year's pay uplifts, failing chief executives would have seen up to £15,000 docked from their salaries. But it's not all stick – we'll reward success too. That is why we're introducing potential bonuses of up to 10 per cent for those who deliver exceptional results. And we will support trusts that are struggling by encouraging top talent to take on leadership roles by offering temporary pay boosts of up to 15 per cent. This will light a fire under NHS bosses to drive better care, improve the experience of patients and build a stronger NHS. Your NHS should serve you – not line the pockets of failing bosses. We're learning directly from some of the best businesses across the world on this. They always have an eye on delivery, and by rewarding success and penalising failure they've consistently driven up standards. And high standards are exactly what I want to see for our NHS as we get it back on its feet and make it fit for the future through our Plan for Change. So my message to NHS leaders is simple: no reward for failure, but plenty for success. Together, we'll rebuild the NHS to serve patients.
