ICB plans to ‘decommission outpatient clinics’

Greater Manchester Integrated Care Board has proposed the move as part of a wide-ranging review of community services. 

The ICB’s draft 2024-25 operational plan, seen by HSJ, said: “On completion of year 1 [of the review], when services are realigned and sustainably transformed, year 2 intentions will be to de-commission outpatient clinics from secondary care and [transfer them] into community and primary care services allowing for estate rationalisation and improved flow.

“This will release productivity benefit with opportunity for 2025-26 financial benefit for provider trust cost improvement plans.”

As part of the review, Greater Manchester said it would identify “priority services” and give them “clear interface guidance” on how they must work with acute services to reduce demand for outpatient clinics. The “priority” list will include virtual wards and urgent community response services. 

NHS England has set the service a target to reduce the proportion of outpatient appointments which do not result in a complete pathway and therefore do not attract a “procedure tariff”. The previous target, to cut follow-up appointments by 25 per cent, saw little progress.

GM’s plan said its review would also lead to a “radical transformation” of “step-up step-down” services.

A primary and community care-based model would be established in the system’s places. This would link primary care networks, same-day emergency care and discharge to assess services, it said, with an aim to reduce attendance at accident and emergency.

The review of community services will drive “full integration” with wider system providers, delivering more care in the community, a focus on early prevention, and ways to “create a skilled, resilient and sustainable community workforce”.

Greater Manchester’s acute trusts largely manage its community services.

Greater Manchester told HSJ the work is part of an “ongoing review” of community services by commissioners, but did not give any further detail by the time of publication.