Outpatient services

Brief description of the project

The NHS ten-year plan (NHS, 2019) lays out a radical shift in how healthcare will be delivered in which patients get more options, better support, and properly joined-up care at the right time in the optimal care setting.

It commits to a fundamental redesign of outpatient services involving three key elements:

• More care provided in community locations and less in main hospitals
• Greater use of technology (including a Health app) and primary care networks
• Patient-driven and patient-managed care, enabled by more empowered patients

We knew that a vast amount of insight into people’s views of these three elements already existed. We commissioned a research company to analyse the existing information, identify any gaps and produce a report to help the NHS in Leeds to redesign their outpatients services.

How did we undertake the research?

We reviewed a vast range of relevant views from patients and the public in Leeds, and across West Yorkshire and Harrogate from the previous three years. This included a review of published academic literature.

The evidence was summarised to show how it maps onto these three elements of the long-term plan.

How did we add to the research?

To supplement this research, we carried out a series of interviews with staff who already have been involved in setting up community-based and technology-based appointments. This included interviews with patients and families who have used these appointments.

What did the research tell us?

• Patients support the change, providing they retain choice about how and where they access their care
• Community clinics where GPs and consultants work collaboratively can increase GP confidence to manage care for longer in primary care. Patients have greater confidence in care delivered by their GP.
• A blended model is best, where patients receive both face-to-face and video consultations.
• IT and administrative support for satellite clinics and video consultations, present challenges.
• With help to set up their technology and the option of a face-to-face appointment, older people will find a move to technology-based clinics acceptable.
• Motivated staff can help break down traditional barriers

You can read the full report below:

What did we do?

The report was shared with the citywide outpatient steering group, however, the report publication coincided as the COVID-19 pandemic began to escalate. This meant many of the changes, such as video appointments had to be put in place quickly.  Patients’ views continue to be gathered by hospital clinics, primary care, and a range of digital inclusion groups to find solutions that support people to access services using technology. Face to face appointments also continue in COVID-19 secure settings.