• NHSI identifies £700m of potential savings in outpatient services
  • It comes ahead of major outpatients overhaul in NHS long-term plan, HSJ understands
  • Development follows Simon Stevens branding outpatient services obsolete in June

NHS bosses have identified £700m of potential savings in outpatient services as part of an overhaul of the £10bn workstream.

A paper by a senior NHS Improvement director discussed at the regulator’s December board meeting yesterday said the “outpatient improvement programme [had] identified an opportunity to improve the way outpatients are delivered with potential savings of £700m”.

The paper provided no more information but senior sources familiar with negotiations told HSJ they expected a bold ambition on outpatients to be a cornerstone of the delayed NHS long-term plan, which could now be published next week.  

HSJ understands senior NHS England figures were pushing for a pledge to radically cut expenditure by a third or more.

See Performance Watch: A new outpatients target for further analysis on what is set to be an issue of increasing importance to trusts and system leaders

It is not clear what pledges made the final version of the plan, but the programme is set to propel the issue up trust leaders’ agenda.

The news follows NHS England chief executive Simon Stevens branding the NHS’ outpatients system as an “obsolescent mode” of care in June.

He said: “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 redesign looks like there, and, in a way, everything else follows from that.”

Outpatient appointments have nearly doubled from 60.6 million to 118.6 million since 2005-06, a faster growth rate than any other aspect of hospital activity, according to NHS England. And there is wide consensus across policy and clinical experts that outpatient services are in dire need of reform.

However, how to reform the services remains the subject of much debate (See Performance Watch)

NHS Improvement has been asked for further details on the new savings programme.

Report author NHSI executive director for improvement Adam Sewell Jones commented on the story following publication.

He said: “In order to add some additional clarity to the story, as it was my board paper that has been referenced, the outpatient programme is not strictly a savings programme, but rather a redesign programme that seeks to improve value for patients by better use of existing capacity, reduction of unnecessary appointments and a shift to more digital options.

“Whilst the focus is on reducing patient waiting and improving patient experience it also has the potential to yield significant financial benefits. Rather than a blanket approach, local data has been shared with trusts, good practice examples shared through networking events and introductions to digital options made.”

UPDATED: This story was updated to include Mr Sewell Jones’ comment at 13:10 on 13 December