Over the last 10 years, outpatient services in England have had the sharpest rise in activity of all hospital services (NHS England, 2017).
Over 110 million outpatient appointments are now scheduled each year (NHS Digital, 2017). Many sustainability and transformation partnerships (STPs) have outlined ambitious plans to cut costs by reducing outpatient activity. Mid and South Essex, for example, hopes to reduce outpatient activity by 16%. Leicester, Leicestershire and Rutland intends to reduce outpatient activity by 30% by removing unnecessary new and follow-up appointments. Durham, Darlington, Tees, Hambleton, Richmondshire and Whitby hopes to achieve a 20% cut in consultant-led first outpatient appointments. Most do not set out detailed plans for transforming outpatient pathways in order to realise these ambitions. As our work shows, transforming outpatient services is complex and is very often specific to particular clinics – and activities within them.
The Nuffield Trust held an event in collaboration with NHS Improvement to hear from health leaders across the country who have made significant changes to their outpatient services. The work reveals there are big opportunities to improve the design of many elements of outpatient services – including referral processes, how follow-up appointments are made, and clinic design. In some cases, there is also cause to challenge whether the services need to be delivered in their current form.
Castle-Clarke S, Edwards N (2018) Rethinking outpatient services: Learning from an interactive workshop. Nuffield Trust