Robotic Services in the UK-

The Role of Superspecialisation

Christian BachConsultant Urological Surgeon

Freeman Hospital, Newcastle, UK

European Manpower Perspective

Robotic Systems in the UK

• Around 50 robots in the UK (2 private) – 66 in DE

• South more than North – (Private Practice)

• NHS England funds RALP/RPN

• Further funding for RARC questionable No new centers to offer procedures

Funding of RALP

Multidisciplinary Programme

Centralisation – London Cancer

Caseload and Outcome

Vickers, J Natl Cancer Inst 2007;99:1171–7

Caseload and Outcome

Vickers, J Natl Cancer Inst 2007;99:1171–7

The Newcastle Consultant Body

Problems with Superspecialisation

• Nobody wants to do general urology any more

• Long travelling times for patients

• Needs working Hub and Spoke system (aftercare)

• What happens if somebody gets sick

• Jealousy from the non specialized surgeons

• 150 Cases – influencing patient selection?

• Don’t be a one trick Pony!

Summary

• Existing robotic systems not used efficiently

• Attempt to Increase outcomes/efficiency through Centralisation

Multispecialty programs

Superspecialisation