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Views And Reviews Provocations

Bring outpatients into the 21st century

BMJ 2018; 361 doi: (Published 06 June 2018) Cite this as: BMJ 2018;361:k2472

Re: Bring outpatients into the 21st century

We thank you for your recent article highlighting the increasing mismatch between patient need and service delivery in NHS outpatients. Even Simon Stevens himself was quoted calling outpatients ‘obsolete’ just yesterday at NHSConfed.
As many reports and the responses to your article have demonstrated there is variation around the country with some areas adapting the traditional model. These can include the introduction of technology offering better accessibility, and arguably quality of care, to certain cohorts of patients. However, when embarking on the design of a new service it is vital to ensure that all patients can continue to receive high quality care and not just technophiles. Similarly this should not be used as an excuse to maintain the status quo. It is clear that a ‘one size fits all’ approach to outpatient delivery is no longer adequate and that patients crave personalised delivery that meets their clinical and social needs.
The Royal College of Physicians Sustainability programme is currently producing a report challenging the current model and thinking around outpatient care. The topic was broached from a sustainability perspective; looking at resource allocation and opportunities to maximise clinical value. The report is based on discussions from several focus groups exploring the purpose of outpatient care and barriers to change. It will culminate in a series of principles for delivering high quality, patient centred and sustainable outpatient services. The report will be published in the autumn.

ii Lord Carter. Operational productivity and performance in English NHS acute hospitals: Unwarranted variations. Dept. of Health and Social care.

Competing interests: No competing interests

14 June 2018
Jenny Isherwood
Clinical Fellow for Sustainability
Dr Toby Hillman Clinical lead for RCP Sustainability Programme
Royal College of Physicians
11 St Andrews Place, London