Rethinking outpatient services: Learning from an interactive workshop

Outpatient services in England have experienced a sharp rise in activity, leading to many STPs outlining ambitious plans to reduce activity and cut costs. This briefing, in collaboration with health leaders across the country, reveals opportunities to improve the design of services and challenges if some services should be delivered in their current form.

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.

Clinician involvement vital to rethinking outpatient services 30/08/2018

Press release

A two-way conversation between GPs and consultants has the potential to treat more patients in the community and support clinicians in their decision making.

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NHS Improvement

Suggested citation

Castle-Clarke S, Edwards N (2018) Rethinking outpatient services: Learning from an interactive workshop. Nuffield Trust