RCoA response to the Call for Contributions for the Commission on the Future of Surgery

The Royal College of Anaesthetists (RCoA) has submitted evidence to the Royal College of Surgeons of England’s independent Commission on the Future of Surgery.

Our submission recommends that the Commission explores not only the future of surgical technology and innovations, but also looks at how that technology might have an impact on the wider issues of working practices, team structures, training, and the patient pathway and safety.

Summary of recommendations outlined in the RCoA response:

  • We note that the Commission has excluded from its terms of reference, analysis of future NHS funding arrangements or government policy. That is understandable, yet both of these are crucial to enable the translation of any of the Commission’s recommendations into practice. We would suggest that the funding implications of any recommendations are explicitly addressed, so that policy makers, informed by the expertise of Commissions such as this, are clear of what is needed to resource the anticipated or desired developments.
  • In that regard, we note that many of the developments considered are highly innovative. We anticipate that before they are fully implemented, organisations like the National Institute for Health and Care Excellence (NICE) will need to be involved through the relevant guidelines, and that funding models will need to identify and support the introduction of ‘best practice’. Some interventions may remain at the level of ‘innovations’ rather than ‘best practice’. How, and on what evidence the two are distinguished may remain a challenge.
  • We would like to see explicit comment on patient safety in the context of the anticipated developments. We appreciate that the safety aspects of technologies will have been considered ‘automatically’ in their development. Yet, there is now a sophisticated literature base in the science of safety and how principles of safety need to adapt to changing technologies. In other words, the emerging technologies will need to be managed in a way that ensures safety and this should remain a stated priority. Expressed from a slightly different perspective, the Commission will need to place the surgical innovations within the context of other, lower risk treatments, which form part of the care pathway.

You can view the full response here »

22 February 2018