In the last of our blogs on the development of an outpatient strategy, we reflect on what we learned about patient choice, personalised care and treating the whole person.

Patient choice and empowerment

Choice around how to be communicated with and where patients are treated needed improving, according to respondents to the outpatient survey. Choice includes between remote or face-to-face appointments, and between email or letter. Digital communications would reduce time and cost for patients and staff, but not all patients want this despite some preferring this option.

Patient choice was named at the summits as one of the core values of outpatient care. Choice about timing of appointments, promoting self-referral, Patient Initiated Follow Up (PIFU), and how patients receive information, such as remote appointments and patient portals. 

Patient empowerment was also key. This includes providing and signposting information on how to access care, discussing expectations and outcomes about treatment, and providing support about symptoms and treatment. These are all seen as important functions of outpatient care, and increased patient self-efficacy can lead to better patient outcomes. 

Personalised care

Shared decision making was an area the NHS could improve, according to the survey responses. Some patients reported inadequate information pre, during and post consultation/treatment, with around two-thirds (61%) of respondents feeling they were given sufficient information. 

If personalised care was in place, patients would feel more able to do shared decision making. Respondents commented on having to find out the information for themselves, searching the internet, feeling the need for second opinions, and feeling unable to ask questions or have any discussion with the clinician.   

Conversations during the summits included consideration of how we build systems to be flexible enough to account for individual patient needs. This included the duty to deliver equitable care and deliver reasonable adjustments, to recognise invisible non-physical impairment, and support available through carers and the third sector. Personalised care should be a minimum standard. 

Whole holistic care

The attitude of staff, and in particular consultants, was raised frequently in the survey. Patients did not feel involved in decisions about their care and treatment; did not feel listened to; and were treated like a number rather than a person, with a lack of empathy and sensitivity.

Supporting patient wellbeing, including their psychosocial care needs, and treating the whole patient were aspects of delivering good care that were brought up in the summits. 

How to support patients in ways that enabled them to be healthy, were discussed, as well as patient activation and self-management where appropriate. Patient education, peer support, social prescribing and the role of charities can all help in supporting patients with good quality information and support services. 

Holistic care differed for those on short-term and long-term pathways; and a joined-up approach across all sectors supported by commissioning is a desired way forward.

The new outpatient strategy is due to be published in the New Year and we hope to see these themes set out in it.

Read the previous blogs in this short series What patients want from an outpatient strategy and Kindness, reasonable adjustments and consistency needed across outpatients.