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Number of outpatient appointments to be cut

Outpatient services to be redesigned to reduce appointments by a third

Ingrid Torjesen

Tuesday, 08 January 2019

Up to a third of outpatient appointments will be avoided through a redesign of “outdated and unsustainable” outpatients services, NHS England’s 10-year plan* says.

This will mean that patients will be spared 30 million trips to hospital and save the NHS over £1 billion a year, the document says. “This will save patients time and inconvenience, will free up significant medical and nursing time, will allow current outpatient teams to work differently, and will avoid spending an extra £1.1 billion a year on additional outpatient visits were current trends simply to continue.”

Outpatients traditionally can serve several purposes: provide advice and diagnosis for a patient and their GP; follow-up review after a hospital procedure; and ongoing specialist input into a long-term condition.

“Technology means an outpatient appointment is often no longer the fastest or most accurate way of providing specialist advice on diagnosis or ongoing patient care,” the document says.

Better support to GPs will help to avoid the need for a hospital referral, and where they are necessary appointments closer to home and alternatives to traditional appointments such as digital appointments will avoid patients having to travel to unnecessary appointments.

As well as being able to opt to access a GP digitally within the next five years, the document says patients will also, where appropriate, be able to opt for a "virtual" outpatient appointment.

“This is better for patients, supports more productive use of consultant time and enables the capacity of outpatient clinics to be used more efficiently,” it says.

In November last year a report** from the Royal College of Physicians concluded that the current outpatient system was no longer fit for purpose and called for a radical overhaul.

The report said that the current "one-size-fits-all" model needed to be replaced with a more person-centred approach that recognises that people have varying health needs, personal pressures and abilities to self-care or manage.


*The NHS Long Term Plan. NHS England, January 2019.
**Outpatients: the future – adding value through sustainability. Royal College of Physicians, November 2018.

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