A national review of NHS policies and patient perspectives on surgical video: a prospective, mixed methods qualitative analysis.

Abstract

Robust governance policy is a fundamental requirement for the adoption of routine surgical video recording at scale. The true extent of existing local National Health Service (NHS) policies relevant to the recording of surgical video is currently not known, as are patient attitudes to the use of these videos by healthcare providers. This was a prospective, mixed methods qualitative analysis. All 144 NHS trusts/boards in England and Wales were asked to provide policies relating to surgical video between 20th February and 20th March 2023. Policies were assessed in accordance with United Kingdom (UK) General Data Protection Regulation (GDPR) principles. A patient and public questionnaire was performed on 14th September 2024 to analyse public views on the role of surgical video within healthcare and to identify issues surrounding video recording of surgical procedures within the NHS. 143/144 (97.9%) NHS trusts/boards responded to the request. Relevant policies were provided by 43/144 (29.9%) trusts/boards. 35/43 (81.4%) addressed consent processes clearly, 21/43 (48.8%) provided clear statements regarding patient access, and 35/43 (81.4%) policies asserted the trust/board's copyright. 19/43 (44.2%) clearly stated data minimisation and data accuracy requirements. 11/43 (25.6%) stated storage duration and 20/43 (46.5%) specified storage location. 255 members of the public completed our surgical video questionnaire. Identified expected uses of video were education, record keeping, and research; benefits were its use as an educational tool, objective evidence of the procedure, and patient satisfaction; concerns were raised about data privacy, consent, and security. 80/255 (31.4%) of participants agreed that all surgical procedures should be recorded. 186/255 (72.9%) would be interested in their own procedure. Video use for surgical quality assurance (236/255, 92.5%), education (241/255, 94.5%), and research (242/255, 94.9%) was supported. The majority of NHS trusts/boards do not have policies governing surgical video recording, use, and/or storage. The supplied policies addressed UK GDPR principles variably, focusing mainly on consent. Patients strongly support the use of surgical video for quality assurance and education, but there is disagreement if this should be performed routinely. The discordance between patient expectation and current NHS practice for the routine recording of surgical video must be addressed when policy is revised. KL is supported by an NIHR Academic Clinical Fellowship and acknowledges infrastructure support from the NIHR Imperial BRC.