RCSE head links NHS reforms' success to infrastructure investment

LONDON: Any effort to reduce the waiting time for patients relying on the National Health Service is bound to fail without making immediate investment in the NHS’s deteriorating infrastructure and technology.

This stark warning is expected to be issued to the UK government by the President of the Royal College of Surgeons of England (RCSE), Mr Tim Mitchell, in his address at the Future Surgery conference to be held in London, coinciding with rising speculation that the Treasury may revise borrowing rules to facilitate increased capital investment in the NHS.

Speaking to an audience of healthcare and technology professionals, Mr Mitchell will stress the need for urgent funding to drive the necessary reforms. “The prime minister has warned that there can be ‘No extra funding without reform,’” he is expected to say. “Ahead of the forthcoming Budget, I say: ‘There cannot be meaningful reform without extra funding—particularly for our estates and technology.’”

Mr Mitchell will argue that, without substantial investment in surgical capacity and technology, the NHS will struggle to make the “step change” required to reduce waiting lists.

He will add, “If the government is serious about meeting the 18-week target, it must commit to capital investment—even if that requires tough decisions on funding sources. Ultimately, it’s in the best interests of both patients and the economy. We cannot continue working in crumbling hospitals with failing IT systems.”

The speech will draw attention to the severe challenges faced by the NHS, including ageing buildings and outdated technology, which limit surgeons’ ability to increase the number of operations.

Mr Mitchell will cite the example of Epsom and St Helier University Hospitals NHS Trust, where old infrastructure regularly disrupts patient care. "Despite millions spent on maintenance, broken lifts and flooded corridors still result in hundreds of cancellations,” he will say, stressing that short-term fixes are no longer sufficient and urging long-term investment.

Mr Mitchell will also call for new NHS England and NICE proposals to streamline the assessment of medical devices, akin to how new medicines are evaluated. This approach would enable patients to access innovative technologies more swiftly while ensuring that the NHS adopts clinically effective and cost-efficient products.

Mr Mitchell will call on the government to support these plans, saying, “Innovations benefit both patients and the UK economy. The new Secretary of State must back NICE and NHS England in implementing these proposals without delay.”

Mr Mitchell’s address will also highlight significant surgical innovations in the last five years, celebrating the pioneering work of NHS surgeons. He will reference the use of smaller surgical robots at University Hospital Southampton for paediatric kidney treatments, breakthroughs in Ear, Nose, and Throat (ENT) surgeries using robotics, and the groundbreaking gene therapy at Addenbrookes Hospital, which restored hearing for a baby born deaf.

The president will also spotlight the increasing use of virtual and mixed reality technologies in surgical planning and operations, including the successful separation of conjoined twins in Turkey by a UK team using VR and AR technology.

Marking nearly six years since the Commission on the Future of Surgery published its report predicting advancements in medical technology, Mr Mitchell will reflect on the NHS’s progress in surgical care and explore areas where further developments are expected.

As the government prepares its upcoming Budget, Mr Mitchell’s message will be clear: without significant investment in infrastructure and technology, the path to meaningful NHS reform remains blocked.