Outpatient care is no longer fit for purpose

A new report has argued that a new approach to outpatient care is needed if it is to meet growing demand and reduce disruption to patients’ lives.

Outpatients: The future - Adding value through sustainability, published by the Royal College of Physicians, says that the cost to patients and public health of the current approach must be considered alongside the financial cost to the NHS, meaning that the system must be aware of patients having to spend time and money on things like childcare and travel when attending appointments, as well as more obvious frustrations such as waiting times and poor communication.

With the current ‘one-size-fits-all’ model no longer fit for purpose, the RCP recommends replacing it with a person-centred approach that recognises that people have varying health needs, personal pressures and abilities to self-care or manage.

Professor Stephen Powis, the NHS England medical director who wrote the foreword for the report, stressed that ‘the time has come to grasp the nettle and use tech and other innovations to improve patients’ experience and care’. As such, he said the system must analyse ways to cut unnecessary appointments, save thousands of journeys, reduce traffic and pollution and make the NHS more efficient.

Seeking to reduce some of the 118 million outpatient appointments every year, the Royal College of Physicians report estimates that a fifth of face-to-face consultations are not necessary and suggests that health chiefs should embrace Skype, as well as other apps and online tools, so that thousands of patients could be spared hospital visits and time off work or school.

The number of outpatient appointments in England has doubled over the last decade, now accounting for 85 per cent of all hospital activity outside A&E, costing around £200 a time.

Professor Powis said: “The outpatient system is older than the NHS and the time has come to grasp the nettle and use tech and other innovations to improve patients’ experience and care. As part of the long term plan for the NHS, it’s right we look at ways to cut unnecessary appointments, save thousands of journeys, reduce traffic and pollution and make the NHS more efficient.

“For many people, care can be delivered more timely and conveniently closer to home, by specialists at the GP surgery or by using technology in new and exciting ways. This report shows a snapshot of exciting new models already working successfully through apps, skype, text messaging and remote monitoring systems that are changing the shape of care; we need to bottle and spread those examples building a new consensus for the future based on the views of clinicians and patients.”