10 January 2024

Modern Outpatient Care – Principles and practice for patient centred outpatient care

It is an opportune moment for the RCP to reflect on and revise our 2018 guidance and recommendations for modern outpatient care. In doing so we have been influenced by two key factors: the changes driven by the pandemic and the fact that outpatient services are an important environment for education, training and professional development.

Our updated principles and recommendations are a clinical framework for service planning and delivery in the context of the difficult UK national health landscape. Opportunities for outpatient service transformation should be embraced and led by clinical teams, supported by local organisations and systems. We hope that local service can self-assess against the principles in this document and identify priorities for improvement.

In summary, we recommend that:

  1. Improving population health and reducing inequalities must be considered in the design and delivery of outpatient care.
  2. Outpatient service redesign must be based on co-production with patients and carers.
  3. Outpatient service transformation must consider the needs of patients with multiple conditions. It should be a significant element in developing more integrated care involving specialist, primary, community, and social care as well as the voluntary sector.
  4. Training in delivering effective outpatient care must be incorporated into clinical training for all health and social care professionals.
  5. Modernisation of outpatient services must be used as an opportunity to reduce adverse environmental impacts of healthcare.

At the national level, funding should be made available for the evaluation of service models and research into the most effective mechanisms of outpatient delivery.

Dr John Dean, RCP clinical vice president, said:

"Outpatient care is the most common interaction between patients and specialists in the NHS. Practice and processes have changed considerably over the last few years, driven by technology, the COVID-19 pandemic, and increasing patient needs. This change hasn’t been planned, so basic elements required for modern quality care are missing. Now is the opportunity to build well-designed services to meet patients’ needs, and that clinicians find professionally rewarding to deliver. Our updated guidance aims to provide a framework for consistent patient-centred practice and services. Clinicians and patients tell us this is very much needed so that services are developed to meet current needs and improve outcomes and experience.”

Dr Theresa Barnes, RCP clinical lead for outpatients, said:

“I welcome the publication of RCP’s new guidance, which recognises the importance of outpatient care, and will stimulate conversations about how innovation can to lead to improved patient outcomes and experience in the future. I hope organisations will use the guidance to share and implement best practice, to deliver high-quality outpatient care and reduce health inequalities.”

The RCP and NHS England’s Outpatient Recovery and Transformation Programme are jointly working to develop a new strategy for outpatient care, setting out new ambitions for outpatient care and the actions we need take to deliver real change. Please visit Medical Care – driving change for more information and resources related to our work in this area.