NHS outpatients model obsolete, says Stevens

The NHS England chief executive referenced comments by his NHS Improvement counterpart Ian Dalton, who told the NHS Confederation conference earlier in the day that “modernising outpatients” was a significant challenge but that the time had come.

Mr Stevens told NHS managers at the conference in Manchester that the health service’s outpatients model was “an obsolescent mode of specialty long term support”.

He said: “When we are talking about redesigning care…From the point of view of the person with Parkinson’s, the periodic [trip] along to the outpatients for the five minutes with the consultants is probably not the best way of staying in touch with the health system [or report symptoms and get the information needed].

“Likewise, across a lot of other specialties, the fact that we’re spending nearly £10bn on outpatients which is an obsolescent mode of specialty long term support…Think of it from the patients’ point of view, think of it from the clinical teams. Have the conversation of what re-design looks like there, and, in a way, everything else follows from that.”

The comments by the national commissioning boss followed NHSI chief executive Mr Dalton saying modernising outpatient services should be a priority.

Mr Dalton said: “Outpatients were attended by 64 million people last year, and cost the NHS more than £8bn.

“We’ve been talking about modernising outpatients for a long time, the challenge for us is to think about whether in the next five years we’ll be looking at a similar picture. I know this is a big ask, an ask about a major transformation of care.”

He referenced the transformation in mental health services as an example of where the NHS has achieved something similar.

Mr Stevens also set out the priorities for the winter ahead, stating that addressing delayed discharges of care would continue to be a major requirement, as the system looks to free up 4,000 beds and cut long term patient stays by a quarter.

He said an “inclusive” national conversation with patients, the health service, and all other stakeholders would be required from now until the autumn to identify the priorities for the long term plan. An announcement on funding and some of the ambitions is however expected imminently, possibly next week, according to some reports. 

Health inequalities, cancer outcomes and mental health, particularly for children and young people were identified as likely priority areas, he said.

UK children were suffering the effects of a “double epidemic” with the impact of childhood obesity and the “stresses and strains of adolescence”, Mr Stevens said.

He said his concerns around obesity stretched beyond exercise, citing concerns around high calorie foods. But he stated that the average Briton spends more time “on the toilet than exercising” as evidence that lifestyles must improve.