Presentation (CTI)

OBJECTIVES: The NHS faces pressure to improve productivity, reduce backlogs, and protect cancer capacity within fixed financial allocations. While increasing day-case surgery is a key focus, minimally invasive technologies offer more cost-effective routes to optimising resources. The shift from coronary artery bypass grafting to percutaneous coronary intervention demonstrates this, with PCI-to-CABG ratios rising from 2.5:1 in 2005 to 7:1 in 2025 , saving upfront costs, and hospital resources. Benign thyroid disease remains resource-intensive, relying on theatre time and inpatient care despite availability of interventional radiology (IR) ablation techniques. This study evaluates national payer value from shifting suitable benign thyroid cases from surgery to IR pathways.
METHODS: A national health economics and productivity analysis was undertaken using NHS activity estimates, National Cost Collection data, and strategic planning guidance. The analysis focused on patients with symptomatic benign thyroid nodules eligible for ablation. Current thyroidectomy costs were compared with IR day-case pathways from NHS perspective, incorporating procedural costs, theatre utilisation, and opportunity costs linked to cancer capacity and elective recovery
RESULTS: Approximately 10,706 thyroidectomies are performed annually in England, of which 56.5% are benign. Approximately 2,422 procedures annually could shift from surgery to minimally invasive IR pathways. Average total hospitalisation costs were estimated at £5,583 for surgical thyroidectomy versus £1,333 for IR ablation, generating net savings of approximately £4,250 per patient , a 76% reduction. This equates to potential annual NHS savings of £10.3 million per year nationally. Each avoided thyroidectomy released approximately 1.5 theatre hours. Nationally, this could release ~3,500 theatre hours annually, or 450 full-day operating lists that can reduce the waiting list
CONCLUSIONS: Shifting appropriate care from surgery to interventional radiology represents a scalable NHS productivity intervention that reduces expenditure, releases surgical capacity and supports cancer objectives. From a national payer perspective, IR thyroid ablation offers a high-value pathway redesign aligned with NHS priorities.