New guidance demands robust training and governance as robotic surgery rolls out across NHS hospitals

The Royal College of Surgeons of England (RCS England) has issued new guidance urging NHS Trusts to strengthen training and tighten governance for surgeons performing robotic procedures, amid growing use of the technology in operating theatres. 

The recommendations come as robotic-assisted surgery (RAS) becomes increasingly common across NHS operating theatres, offering benefits such as enhanced precision, reduced blood loss, faster recovery times, shorter hospital stays and improved patient experience. RAS has been used in the UK for over a decade, particularly for urology procedures. RCS England has emphasised that, as more surgical specialities adopt the technology, there needs to be robust oversight and comprehensive training to ensure its continued safe roll-out.  

Currently, there are no standardised NHS protocols or minimum training requirements in place and adoption varies widely between Trusts.  The updated guidance, Robotic-assisted surgery: A pathway to the future sets out a strengthened national framework to ensure safe, consistent, and evidence-based roll-out across the NHS.  

Earlier this year, the government and NHS England announced that millions of patients will benefit from cutting-edge NHS robotic surgery over the next decade, as part of radical plans to cut waiting times.   

Miss Nuha Yassin, Consultant Colorectal Surgeon and RCS England Council Lead for the Future of Surgery, Robotics and Digital Surgery, said: 
 
“The government is championing robotic-assisted surgery for its significant patients’ benefits and potential to help cut waiting lists. While this is exciting, the pace of innovation must be matched by rigorous standards.   

“That is why RCS England has published updated guidance which sets out what NHS trusts need to do to strengthen the training and governance of surgeons undertaking robotic procedures. This includes simulator training, cases supervised by experienced proctors and robust competency checks.  

 “It is also essential that, as robotic surgery is introduced more widely across the NHS, surgical residents receive the same structured training opportunities as consultants.”   

The updated guidance aims to improve patient safety and consistency across hospitals as robotic procedures become more common in the NHS.  It also provides clear national standards for training, competency, and governance, drawing on the latest evidence and policy from the National Institute for Health and Care Excellence (NICE), the British Orthopaedic Association (BOA) and GIRFT/NHS England.  

It sets clear expectations for hospitals, training bodies, and surgical teams, supporting workforce development and professional development in robotic-assisted surgery.  

Key updates and recommendations for NHS Trusts include:

• Minimum simulator training requirements to build foundational skills – baseline structured practice on robotic surgery simulators that a surgical trainee must complete before progressing to real patient cases. 

• Structured proctored cases and competency assessments before independent practice – a formal, supervised stage of training that ensures surgeons are safe and competent before operating independently. 

• Formal governance structures to be set up in every Trust, such as Robotic Surgery Governance Groups - to approve independent practice, review data, and oversee safe implementation. 

• Emphasis on teamwork and structured learning - highlighting collaboration as essential for high-quality surgical practice.  

RCS England will regularly review the guidance to reflect emerging evidence, new technologies, and best practice, ensuring surgical teams are equipped with up-to-date standards and support for safe, effective practice.  

ENDS

Notes to editors:

• The updated guidance, Robotic-assisted surgery: A pathway to the future, can be found at: Robotic-assisted surgery: A pathway to the future — Royal College of Surgeons 

• The Royal College of Surgeons of England provides world-class education, assessment, and development to 30,000 surgeons, dental professionals, and members of the wider surgical and dental care teams, at all stages of their careers. Our vision is to see excellent surgical care for everyone. We do this by setting professional standards, facilitating research and championing the best outcomes for patients.    

• For more information, please contact the RCS England press office: telephone: 020 7869 6053/6054/6060; email: pressoffice@rcseng.ac.uk; out-of-hours media enquiries: 0207 869 6056.