Transforming outpatient care

Providing care to ‘outpatients’ is central to specialty medicine and the RCP has a key role in the development and improvement of these services.

‘Outpatients’ describes people who require specialist care without the need for a hospital stay. It can also describe the service providing consultation between a patient and member(s) of a specialist team. In the UK, new referrals for outpatient care are predominantly triggered by primary care or other specialist practitioners.

Outpatient care accounts for a large part of NHS England activity – in 2021/22 there were over 95 million outpatient attendances. So it’s important that is delivered effectively and efficiently, which is why outpatients features regularly in our news and blog articles and its reform has been a key focus for the RCP in recent years.

A modern outpatient service is delivered by multiprofessional teams, using multiple modes of consultation and assessment, including face to face, remote, group and asynchronous (such as via email). It needs to be supported by significant technical and administrative infrastructure to enable safe and efficient care. Ideally, it should be located alongside support services such as diagnostics and pharmacy.

Outpatient care strategy

What we are doing

In April 2023 we published Modern Outpatient Care – Principles and practice for patient centred outpatient care. It includes principles and recommendations that constitute a clinical framework for service planning and delivery in the context of the difficult UK national health landscape. We hope that local services can self-assess against the principles and identify priorities for improvement.

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

What we have done

Modern Outpatient Care builds on and revises elements of our 2018 report, Outpatients: the future – adding value through sustainability. In that we said that the traditional model of outpatient care was no longer fit for purpose. It placed unnecessary financial and time costs on patients, clinicians, the NHS and the public purse. Growing demand and expectations could not be met by the status quo and it was no longer acceptable to solely consider the cost of clinical interventions in relation to individual health outcomes.

Our view was supported by NHS England national medical director, Professor Stephen Powis. In a blog article, Professor Powis said, “It’s the correct diagnosis, and the principles and recommendations suggested are the right prescription. But they mean nothing unless all of us, as a healthcare system, commit to embarking on and seeing through the course of treatment. While potentially painful, uncomfortable or disruptive, addressing this challenge is absolutely vital.”