Patients in England face a postcode lottery for robot-assisted surgery on the NHS, an investigation has found.
The study, based on Freedom of Information requests, found London has 28 robotic surgical systems across its NHS trusts, compared with just six across the South West of England.
There is no standard funding model for the equipment, which costs between £500,000 and £1.5m, leaving local health leaders to decide how to acquire it.
Some trusts are using capital funding to buy the machines, while others are leasing them or relying on charitable donations from local residents.
Royal United Hospitals Bath NHS Foundation Trust, for example, spent more than £2m in donations on robotic platforms.
Royal College of Surgeons of England president Tim Mitchell said: “Robotic-assisted surgery can transform care and help reduce NHS waiting lists, but access remains a postcode lottery.
“For one of the Government’s five ‘big bets’, it is extraordinary that some NHS hospitals are having to resort to local fundraising to raise vital funds.
“It’s clear from this data that there is an urgent need for more grip on where robots are located and how they are funded, to ensure robotic-assisted benefits all patients, not just those in the right postcode.”
Robot-assisted surgery typically involves surgeons controlling precision instruments using a console and a camera.
Experts say the machines can make movements more precise than the human hand, with benefits said to include faster recovery times, fewer complications and shorter hospital stays. In some orthopaedic procedures, robots are programmed to carry out parts of an operation.
The findings, described as the first publicly available national picture of how surgical robots are being used across England, were due to be published at the Future of Surgery Festival in Birmingham by the Royal College of Surgeons of England.
The government has identified robotics as one of five “big bets” in its 10 Year Health Plan for England. Medics carried out 70,000 robot-assisted procedures in the NHS in England in 2023/24, and that figure is expected to rise to 500,000 over the next decade.
Health officials say nine in 10 keyhole surgeries could be delivered with robotic assistance by 2035, up from around one in five currently.
The National Institute for Health and Care Excellence approved 11 robotic systems for use in the health service last year.
However, the college warned there is a “clear gap between national ambition and frontline reality”, adding that decisions about provision are often made locally rather than as part of a joined-up NHS strategy.
It also said there is no single, transparent national dataset on robotic surgery provision, making it difficult for NHS England, the Department of Health and Social Care and integrated care boards to plan services, assess equity of access and ensure value for money as robotic surgery expands.
The college said not every hospital needs its own surgical robot, but all patients should have equitable access to hospitals and surgeons that provide robotic surgery.
It is calling for a national public directory of surgical robotic systems, a clearer and more consistent funding model including centralised capital funding, and money to cover training costs.
It also wants industry to make the machines more affordable, create more flexible financial models for trusts and provide more support for refurbished models.
A Department of Health and Social Care spokesperson said: “Robotic surgery is making a huge difference in our NHS today, with these cutting-edge machines speeding up treatment, reducing recovery times and allowing patients to return to normal activities more quickly.
“As set out in our 10 Year Health Plan, the NHS is committed to the adoption of robotic-assisted surgery for an expanded range of procedures.
“This is just one of the ways in which we will continue to drive forward the very best standard of care for patients.”
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