Innovative NHS and industry partnerships, forged in the unprecedent response to COVID-19, must now continue to help clear the serious backlog in elective surgery, writes Hugo Breda, Managing Director of Johnson & Johnson Medical Devices, UK & Ireland.
I have never experienced anything like the COVID-19 pandemic in my entire professional career. I do not think anyone working in the healthcare industry has. The societal and economic impact has been monumental, hospital and ICU capacity has been stretched up to and beyond its limits, and healthcare professionals have performed heroic yet exhausting feats.
There was no blueprint when COVID hit, no guidelines for how to respond to such a rapidly unfolding crisis, and yet the NHS rallied magnificently, driven by the superhuman efforts of doctors, nurses, and other frontline staff. To meet the pandemic’s ever-changing demands, resources were redeployed at speed across our healthcare system, with hospitals in particular transforming almost overnight to meet new demands. Entire wards were given over to COVID-19 patients, with doctors and nurses pulled in from other areas to staff them and the expanding intensive care units.
I’m proud to say that the medical devices industry played its part in this response too, creating partnerships with the NHS by leveraging our extensive expertise, as well as the best and latest that science and technology had to offer. We adapted to support surgical teams virtually, revamped digital training programmes for healthcare professionals to ensure vital skills were not lost, and supported the rapid reconfiguration of NHS surgical services. We deployed our dedicated Services & Solutions team to work across a variety of NHS Trusts to improve delivery of services: making improvements to theatre scheduling and utilisation, increasing efficiencies to allow for additional cases and decreasing the length of patient stay.
It was a partnership borne out of necessity that delivered for patients, but now, as we tentatively emerge from the worst of the pandemic, it is vital that this collaboration continues to overcome our next great challenge: clearing the backlog of elective surgery.
Despite the incredible efforts throughout the pandemic, there have of course knock-on effects from lockdowns and reconfigurations which saw many non-essential treatments postponed. The latest NHS figures recently revealed the scale of the resulting surgery backlog: approximately five million people are awaiting procedures, including life-changing operations like hip and knee replacements, with 436,127 of these waiting more than a year. These are truly shocking figures but are more than just numbers: they represent patients left in pain and lives put on hold.
Now, with the UK’s successful vaccination programme continuing at pace, it is time to start addressing this backlog, and it should be the focus for all of us who work in surgery and orthopaedics, be that in the NHS or industry. The NHS is acutely aware of the problem, and the recent announcement of a £160 million initiative to tackle waiting lists and develop a blueprint for elective recovery is to be welcomed. But given hospitals cannot simply double the number of surgeons and operating rooms to catch-up, the key question remains: exactly how can this recovery be implemented and achieved at pace?
The answer, I believe, lies in the continued close co-operation between the NHS and industry, forged so brilliantly during the pandemic, with strong connections into the wider ecosystem of academia, science, and Government. For the NHS, this means fully embracing the medical device industry’s unrivalled expertise, and the adoption of digital and medical innovation. For the industry itself, it means standing up and delivering the innovative solutions and value-based healthcare that the NHS so desperately needs right now. Both sides must deliver if we have any hope of succeeding.
One obvious area for such a partnership is industry supporting surgical teams to work in a more effective, efficient, and consistent way, whilst maintaining patient outcomes – helping them perform more operations each day and ensuring patients are successfully discharged afterwards (after all, there’s no sense in moving patients along more quickly only to see them back in clinic with a complication a week later). If we apply this to the specific example of knee-replacement surgery, the benefits of such an approach are clear.
In one recent case, we partnered with an NHS Trust utilizing our digital workflow system technology. It enables theatre teams the opportunity to choreograph their OR with synchronized surgical workflows, guiding the entire care team seamlessly through every surgery, tracking, analysing and interpreting surgical performance with real-time insights. Using this technology, along with embedding a number of other efficiency improvements, has resulted in the surgical team increasing the number of knee-replacement procedures they can complete in a single day by over 50%. If this kind of collaboration can be replicated across the NHS then it would greatly improve the rate at which surgery can be conducted.
Staying with knee replacement operations. These typically take 45-90 minutes, depending on numerous factors, one of which is the type of knee implant. More advanced implants that do not require cementing in place, but rather form a direct bond with the patient’s bone, can save an average of 11 minutes per knee surgery. In a hospital running five operating rooms, simply switching to cementless implants could translate into five extra patients a day – a seemingly simple switch with potentially far-reaching consequences.
These examples of collaboration are just from the operating room but of course, the patient pathway starts long before, and continues long after. The opportunity for partnership is there throughout – be it cutting administrative burdens, facilitating surgeon-patient communication, shortening the average length of stay in hospital, or minimizing post-operative complications.
The pandemic showed how the NHS and industry can partner to rapidly meet emergency needs, but as that immediate emergency begins to pass, we must continue our work together to tackle the aftermath – a growing issue that I am sure will become the defining healthcare challenge of the post-COVID world. But no matter where and how these partnerships might deliver, the philosophy of increasing efficiency and quality must sit at their heart, and they must fully embrace the clear benefits that digital technologies have to offer.
