The elongated time frames from primary evidence to implementation as standard of care have long been a source of frustration for surgeons and patients alike. In many health organisations, not just one the size of the NHS, the processes are complex and Byzantine, with multiple barriers to adoption [1]. While many of these issues are out of our hands as clinicians "on the shop floor" and relate to organisational structures and funding mechanisms, there are facets that are within our gift, or at least partly. The Nuffield Trust highlighted in 2018 the challenges that arise within healthcare with an inherent dichotomy between implementing new technologies and