There is an opportunity to revolutionise the surgical practice through wider use of robotics to improve hospital bed utilisation and reduced complications by capturing real world data across the surgical pathway including data from theatres.

Each year 10 million patients undergo a surgical procedure in the UK. Surgery accounts for £12 billion (10%) of the NHS budget and a similar amount is spent on dealing with adverse surgical outcomes. The latter will undoubtedly increase as our ageing population comes to require surgical interventions. 

Older people suffer from multiple medical conditions (multi-morbidity), including frailty, which explains why one third of all deaths in the UK occur in patients within 90 days of surgery. This will be further compounded by patients waiting much longer to have their operation. This is the challenge we will address.

Digital Surgical Pathway (Digital Surgical Twin) will be driven by data from patients, surgical navigation tools and robots, captured throughout the surgical journey.  The multi-source data will be exploited in two ways to transform surgery:

·         To improve outcomes and reduce NHS beds dependency by creating personalised surgical plans that take individual health factors into account.

·         To transform future workforce training in surgical and non-technical skills through enabling human experience platforms and enhanced cognitive technologies such as augmented/virtual reality and simulation.

The main drivers for change are significant developments in the fields of:

·         Robotics: robotic surgery can significantly reduces hospital bed utilisation, post-surgical complications, and NHS costs. Kinematic data of surgeon’s hand and finger movements in robotic surgery can be curated, which we can analyse to predict the outcome of a procedure.

·         Data and AI: big data and AI are transforming many fields, particularly in healthcare, which accounts for two thirds of all the data generated.  Joining patients’ longitudinal medications, genomic and multi-morbidity data, along with dynamic data from electronic health records and data extracted from surgical robots will generate personalised surgical plans.

·         Augmented/Virtual Reality:  Augmented/Virtual Reality can, if combined with properly structured educational content, accelerate improvement in surgical skills. It can also track the attainment of competencies more objectively than can currently available methods that depend on subjective human judgement.

This will require core investment into A National Health Data Research Hub in Surgery.  It will be a unique ecosystem at a national level, built around a trusted research environment (TRE) with access to data on patients’ surgical journeys that is unavailable elsewhere. This will be used to create a personalised digital twin of a patient’s surgical journey across all interventions.

The Hub will be an outward facing organisation involving diverse and complementary cross-sector partnerships and capabilities. There is an agreement in principle to develop the data hub in partnership with HDR UK and incorporate it into their current network of eight hubs. This will de-risk and rapidly advance the creation of the data hub.