We’ve been working with NHS England and the Royal College of Physicians on the outpatient strategy for a year now. This is the first of three blogs about what we’ve heard from patients about outpatients. For some background on this project, read our blog from earlier in the year.

We’ve run a patient panel, which has presented its feedback at outpatient summits, and run a survey on what patients want from a strategy. The themes that were discussed across the four summits were similar to what we found in our survey.

Coordination of care

In our survey, patients and carers reported having no opportunity to book an appointment at a time of their choice or choose the method of communication; some had to chase for an appointment.

Some people said they were pressured into taking appointments they didn’t want or that the coordination was disjointed and lacking in information. 

We asked respondents what the most important aspect of outpatients was for them; more than three quarters (77%) said the speed at which their appointment is arranged.

The importance of good administration was raised at the summits. Administrative staff are usually the first contact for patients. Their ability to communicate with patients empathetically and compassionately is central to good patient experiences.

Care coordinators and patient navigators should support patients access the right care pathway. Better coordination of appointment times, especially for people seeing several different specialities, and an improvement in timely appointments would also improve patients’ experiences.

Communication

Our survey found a minority received a text or email, while just under three-quarters (74%) were contacted by letter. Only a quarter (27%) of the survey respondents who had been asked what communication method they preferred were communicated with in the way they’d requested. 

Most respondents hadn’t received any information before their appointment, causing confusion and stress; they resorted to searching online for information. Patients had inadequate information before, during and after the consultation or treatment. Patients want choice in how to communicate, including email rather than letters. 

The need for improved communication between healthcare professionals, and between healthcare professionals and patients, was cited in all summits; again, before, during and after the consultation.

Communication is key to reducing Missed Appointments (once called Did Not Attends) and facilitating better care across all parts of the system including social care, community care and public health services.

Digital health

Survey respondents wanted the potential for more remote appointments, which could reduce time and cost for patients and staff, while recognising not all patients wanted this. Only half of respondents (54%) who had a virtual appointment felt they had the right information beforehand to help make the most of it. This concerns us because lack of information means patients did not know what was to happen in their appointment. This is in line with themes around inadequate communication.

Throughout the summits, digital transformation and innovation were seen as needed for quality care, recognising the importance of flexibility to respond to patient preferences and needs. Without this, digital tools could act as a barrier to good quality care. Digital tools such as patient portals and patient-facing apps can support more seamless communications and better access to care. 

Summit participants suggested some patients would receive faster access to care through digital self-referral pathways. Digital tools could enable three-way communication between patients, referrers, and specialists. This would enable patients to have more autonomy around timing and need for care supported by better access to reliable information.

In the next blog, we will look at training, health inequalities, integrated care, and the workforce. 

The outpatients survey was conducted during the last three weeks of September 2023.

Summits were held on 25th May, 21st June, 6th July, and 14th September 2023.

Read the other blogs in this short series personalising care and offering patients choice and Kindness, reasonable adjustments and consistency needed across outpatients