Table 1

Participants' experiences of governance for new procedures

Example quote
Procedure considered and approved by trust’s new procedure committee“There’s one surgeon in [European country] who described the procedure, and the surgeon in [Asian country] who had done some of these procedures, but not really clear on how they’d done it. I contacted the [European] surgeon. He gave me some pointers, so I discussed it with my colleagues, and of course put it through the governance processes as a novel and a new procedure. And then we did it.” (Surgeon 31, Colorectal, Male, Trust 8)
Approval from trust’s new procedure committee deemed unnecessary as felt to be a variation of established procedure“We asked about it to the new procedures committee, but they said well it’s basically [variation of established procedure] isn’t it. The technicalities of it are lost on non-thoracic surgeons really, which is good.” (Surgeon 31, General Surgery, Male, Trust 8)
“There’s a new technique that’s probably done by no more than 9 or 10 surgeons in the country. Again, it’s a new technique, it’s only been reported in the last 3 or 4 years.(…)Because it was under the umbrella of [broader procedure), I didn’t have to go through any, so within the hospital there’s a board about new techniques, you have to sort of, clinical effectiveness group, you have to have that approved. But, because this was a variation, we didn’t need that approval.” (Surgeon 22, Male, Orthopaedics, Trust 7)
Procedure evaluated in the context of a research study We were looking [procedure], and so that was in the guise of a randomised double-blind trial that we put through Ethics. So that would be innovative. We’ve got an Ethics Committee, and as part of that if you were going to be doing something really brand new that would have to be conducted as part of a trial, so, but when there’s a blur between doing something slightly different then no I don’t think it’s the place for that(…)I can’t think of anything where they’ve been involved in, you know, anything that we’re doing.” (Surgeon 46, Male, Orthopaedics, Trust 22)