The NHS long term plan sets out key commitments to transform care to ensure as health needs, medicine and society change the NHS keeps moving forward to create a future proof healthcare service.
One of the key commitments of this plan is to transform outpatient services for patients, which is where the Outpatient Recovery and Transformation Programme comes into play.
Outpatient services within the NHS have been under increasing pressure over the past 5 years, and dramatically more so with the disruption of the covid pandemic. Waiting lists have been growing as outpatient capacity hasn’t met demand, increasing waiting times to unacceptable levels for a healthcare service as great as the NHS. As of August 2022, a record of over 7 million people were waiting for treatment, although recent reports suggest there is 1.5m fewer people on waiting list than thought, due to patients having more than one outstanding appointment.
These pressures are known by the NHS outpatient staff and the increasing workload from Covid and the sustained longer-term pressure, has led to staff burnout and fatigue. This has led to staff looking for new opportunities and makes staff attraction and retention a bigger challenge for the NHS.
To change all this and tackle the outpatient challenges, this transformation programme gives patients greater control and convenience in their appointments. It empowers patients to book their own follow up care when needed and introduces new methods such as remote consultations by phone or video. This has many benefits to staff, patients, and the planet, including less time travelling to hospital appointments and in waiting rooms, and better access to follow-up hospital care when needed. The planet also benefits from reducing the NHS’s carbon footprint and contribution to congestion on the roads - part of the NHS’s target to be net zero by 2045.
What is involved in the Outpatient Recovery and Transformation Programme?
Referral optimisation
In years gone by, GPs referred patients to hospital as a next step from their service but now GPs have much more access to expert clinicians. Advice and guidance is available to GPs and they can gain input from clinicians in the relevant field before referring patients to an outpatient appointment. This can be through phone or video calls with the specialist clinician or by sending images of a patients condition to them.
This speeds up diagnoses and treatment for patients as well as reducing stress from hospital appointments and saving time and money. In the case where a patient is referred to hospital, the engagement with a clinician prior means they can be seen by the right person first time, giving the patient better support.
Video consultations
Remote video consultations have proved a number of benefits:
Increased patient attendance rate, in 2021 DNA’s decreased by 6.7%
Better patient experience and engagement, As per a National Voices Insight Report that found remote consultations as more convenient for some people, taking less time out of their day and easier to attend without having to travel.
Time, money and space efficiencies, as the below NHS data from April 2020 to April 2021 shows
To find out more about the benefits of video consultations, download our whitepaper on redesigning patient care with virtual consultations here.
Personalised follow-up
After an initial outpatient appointment or surgery, follow-up appointments are generally needed for ongoing care. Personalised follow-up means the patient care is fitted to their needs and preferences.
Again this saves unnecessary travel for hospital appointments, saving patients time and money as well as simple convenient care when they need it. Clinicians also benefit from more time to spend with patients who need more support. Some personalised follow-up models are
Patient initiated follow-up (PIFU): this is when the patient decides when they need an appointment based on how they feel, stopping unnecessary appointments. PIFU can be used for patients with long or short-term conditions in a broad range of specialties including dermatology, rheumatology, and cancer. Patients must be able to understand the process and have relevant abilities and facilities to do PIFU.
Remote monitoring: this is when patients are monitored through wearable technology devices or clinical surveys or test results, and the clinician will decide when the patient needs an appointment based on this information. This is typically used for acute and chronic conditions such as heart disease, diabetes and asthma.
Personalised Timed follow-up: this is when a set time is decided between the patient and clinician when they should next have an appointment, based on their needs and circumstances, often used for shorter term conditions or at the beginning of a patients journey when the condition needs monitoring closely. This method is also used if due to circumstances the patient is unable to join a PIFU or Remote Monitoring care model.
Where is this happening?
Throughout the many NHS Trusts, each one is at a different stage of progress on the programme, but it’s an ongoing journey together to improve patient care. Here’s a few examples of NHS Trusts that Spacestor Healthcare have been privileged to work with on the outpatient transformation programme, including strategies of digital transformation and virtual care.
Targeting 30% of their patient consultations to be carried out virtually, they installed Consult Flex virtual consultation pods to provide space efficient solutions to conduct video calls with patients.
“[We] initially implemented remote consultation in response to the COVID pandemic but we are now looking at how we can use video consultation to deliver our services in the future. As part of this work we realised that open plan office spaces and demands on clinical space are a potential limiting factor in how we use these technologies. We are also keen to address inequalities in our service users being able to access these technologies due to digital poverty. We see the Spacestor pod as a potential solution for both of these problems - involvement in this trial is an exciting opportunity for our organisation”. - John Higham, Chief Clinical Information Officer
Remote consultation pods are proving to play a big part in the NHS Outpatient Recovery and Transformation Programme, transforming existing real estate into more efficient clinical space quickly and providing optimised, private, quiet spaces to increase remote consultation outputs. Check out our range here.