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WELCOME TO THE REINFORCE STUDY

A Real-World, In-Situ, Evaluation Of The Introduction And Scale-Up Of Robot-Assisted Surgical Services In The NHS: Evaluating Its Impact On Clinical And Service Delivery, Effectiveness And Cost (the REINFORCE study)

What is REINFORCE?

This study (known as REINFORCE) aims to work out if robot assisted surgery, a relatively new development, should be routinely available in the NHS and also to assess any barriers to its implementation.

Why this project?
Over the next 20 years, surgery performed with the help of a robot (called “robot-assisted surgery”) is expected to increase rapidly around the world, especially for cancer conditions. Previous research shows that when robot-assisted surgery has been introduced in some clinical areas, like urology, it can help surgeons be more precise and can reduce a patient’s hospital stay. Using robot-assisted surgery may also speed up training for surgeons to enable them to become experts more quickly.


However, robot assisted surgery has not been tested in all clinical areas and is very expensive with each robot costing over £1million. Also, when robot-assisted surgery is introduced into hospitals it requires special consideration as the set-up can be disruptive. The robot can take up a lot of space requiring physical modifications to operating theatres. The surgeons and the wider surgical team have to change how they operate, and the way patients move through their patient journey also has to change. It is not yet clear whether the benefits to patients or the health system of doing surgery this way is worth the cost and the disruption. The REINFORCE study aims to answer that question and provide guidelines for the best way of doing it if robotic surgery is shown to be useful.
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Who will be taking part?

We have designed the research to be able to measure the impact of robot-assisted surgery as it is introduced in the NHS and scaled up in other hospitals currently performing robotic surgery but planning to expand services. It will study the effects of robot assisted surgery as it is rolled out at 16 different NHS sites in a planned way. It will measure the safety and benefit of the new treatment as it is being rolled out. We will measure what happens to patients who get robot-assisted surgery as part of the service and compare their outcomes (e.g., complications, recovery time) to conventional surgery.

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We will also track how introducing robot-assisted surgery impacts on the staff and the surgeons, and how it affects wider care in hospitals across the country. We will also work out how much robot-assisted surgery really costs and whether the benefits are value for money.

If you are interested in taking part, or have any questions?

CONTACT US

Where can I take part?

Cardiff & Vale University Health Board - Colorectal

Key people:

Investigator:

  • Mr James Ansell

Address:

Clinical Research Facility
Upper Ground Floor C Block
University Hospital of Wales
Cardiff
CF14 4XW
Cardiff & Vale University Health Board - Gynaecology

Key people:

Investigator:

  • Mrs Sadie Jones

Address:

Research Office
Department of Obstetrics & Gynaecology
University Hospital of Wales
Cardiff
CF14 4XW
Cardiff & Vale University Health Board - Urology

Key people:

Investigator:

  • Mr Krishna Narahari

Address:

Urology Research Team
Urology Cancer Trials Unit
TB2 Room 14
University Hospital of Wales
CF14 4XW
Betsi Cadwaladr University Health Board

Key people:

Investigator:

  • Mr Richard Peevor

Address:

Ysbyty Gwynedd, Betsi Cadwaladr UHB
Research Office, Clinical School
Ysbyty Gwynedd, Bangor
Gwynedd
LL57 2PW
Norfolk & Norwich University Hospital NHSFT

Key people:

Investigator:

  • Prof Iain McNamara

Address:

Orthopaedic Research Team
Clinical Research Facility
Quadram Institute
Norwich Research Park
NR4 7UQ
North Bristol NHS Trust - Colorectal

Key people:

Investigator:

  • Mr Andy Smith

Address:

Research & Innovation, North Bristol NHS Trust
Learning & Research (Level 3)
Southmead Hospital
Bristol
BS10 5NB
South Tees Hospitals NHS Foundation Trust - Orthopaedic

Key people:

Investigator:

  • Prof Paul Baker

Address:

STRIVE Academic Centre
James Cook University Hospital
Marton Road
Middlesborough
TS4 3BW
Swansea Bay University Health Board - Urology

Key people:

Investigator:

  • Mr Gokul Kanda Swamy

Address:

Room 104, Floor 1
Institute of Life Science 2
Swansea University
Singleton Park
SA2 8PP
Stockport NHS Foundation Trust

Key people:

Investigator:

  • Ms Heather Stewart

Address:

Urology Unit
Stepping Hill Hospital
Poplar Grove, Hazel Grove
Stockport
SK2 7JE
Northern Care Alliance NHS Foundation Trust

Key people:

Investigator:

  • Mr Javed Sultan

Address:

UGI Surgery Offices
Level 2, Turnberg Building
Salford Royal NHS Foundation Trust
Stott Lane, Salford
M6 8HD
Salisbury NHS Foundation Trust - Urology

Key people:

Investigator:

  • Mr Rob Ritchie

Address:

Urology Centre
Salisbury District Hospital
Odstock Road
Salisbury
SP2 8BJ
Salisbury NHS Foundation Trust - Colorectal

Key people:

Investigator:

  • Mr Graham Branagan

Address:

Research Department
Salisbury District Hospital
Odstock Road
Salisbury
SP2 8BJ
Wrightington, Wigan and Leigh Teaching Hospitals NHSFT

Key people:

Investigator:

  • Prof Tim Board

Address:

Research Delivery Team, Ward 6
Wrightington Hospital
Hall Lane, Appley Bridge
Wigan
WN6 9EP
Cwm Taf Morgannwg University Health Board - Colorectal

Key people:

Investigator:

  • Mr Paul Blake

Address:

Clinical Research Centre
Royal Glamorgan Hospital
Ynysmaerdy
Llantrisant
CF72 8XR
Oxford University Hospitals Foundation Trust - Pancreas

Key people:

Investigator:

  • Mr Zahir Soonawalla

Address:

NDS Research Office, Urology Administration
Churchill Hospital
Old Road
Oxford
OX3 7LE
Oxford University Hospitals Foundation Trust - Upper GI

Key people:

Investigator:

  • Mr Sheraz Markar

Address:

NDS Research Office, Urology Administration
Churchill Hospital
Old Road
Oxford
OX3 7LE
Cardiff & Vale University Health Board - Renal

Key people:

Investigator:

  • Mr Krishna Narahari

Address:

Urology Research Team
Urology Cancer Trials Unit
TB2 Room 14
University Hospital of Wales
CF14 4XW

Study news

Recruitment

2591/2560

Trial sites

Latest addition to sites:

Cardiff & Vale University Health Board - Renal
Oxford University Hospitals Foundation Trust - Upper GI
Oxford University Hospitals Foundation Trust - Pancreas
Cwm Taf Morgannwg University Health Board - Colorectal

Key facts about the study and documents

What is this study about?

We have designed the study to be able to measure the impact of robot-assisted surgery as it is introduced in the UK and scaled up in other hospitals currently performing robotic surgery but planning to expand services. It will study the effects of robot assisted surgery as it is rolled out at different sites in a planned way. It will measure the safety and benefit of the new treatment as it is being rolled out.

We will measure what happens to patients who get robot-assisted surgery as part of the service and compare their outcomes (e,g., complications, recovery time) to conventional surgery. We will track how introducing robot-assisted surgery impacts on the staff and the surgeons, and how it affects wider care in hospitals across the country. We will also work out how much robot-assisted surgery really costs and whether the benefits are value for money.

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You can find out more information about REINFORCE here:

Download documents:

Participant Information Leaflet (1)

Key contacts

Click on cards to find out more

Key questions & answers

Click on questions to find out more

Organisation

Funding acknowledgement

This project is funded by the National Institute for Health Research (NIHR) Health and Social Care Delivery Research (HSDR) Programme (Ref: NIHR131537). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.