Investigating innovations in outpatient services

RSET investigates the effectiveness of innovations to improve outpatient services and looks at how outpatient activity has changed in England since 2008.


Published: 01/11/2020

Project status: Ongoing

This is a RSET project (Rapid Service Evaluation Team), a collaboration between the Nuffield Trust and UCL and funded by NIHR.

The NHS Long Term Plan set an ambitious aim of reducing the number of face-to-face outpatient attendances by 30 million over the next ten years. In part, this is a reaction to the huge growth in appointments and attendances over the last decade and in part to encourage better ways of delivering care, reducing inefficiencies and improving patient experience and outcomes.

The objectives of this work are to:

  • Review the evidence on the effectiveness of innovations to improve outpatient services and understand the factors that influence how innovations are implemented.
  • Describe how outpatient activity has changed in England since 2008, including outlining how services have responded to the 2020 Covid-19 pandemic.
  • Use time series data analysis methods to identify trusts and specialties whose outpatient activity appears to have changed in practically significant, and positive ways. For example, this might be a growth of non-face-to-face appointments, or a reduction in cancellations and did-not-attends.
  • Use contextual data to identify whether any changes identified might be explained by, for example, changes in population characteristics.
  • Carry out interviews with a small number of trusts to investigate whether specific trends identified might be attributable to particular innovations in outpatient services.

A second phase of the work will aim to robustly evaluate, with mixed methods approaches, a limited number of innovations. These would be selected from a shortlist of services identified during the initial phase, or from other innovations identified by RSET.

View study protocol

Project Team
  • John Appleby
  • Theo Georghiou
  • Jonathan Spencer
  • Sarah Reed
  • Nadia Crellin
  • Jessica Morris
  • Jean Ledger
  • Pei Li Ng

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