A number of experts, including Dr David Fluck, Medical Director at Ashford and St Peter’s Hospitals (pictured) and Professor Stephen Powis, NHS England’s National Medical Director, took part in an online discussion focused on outpatient transformation and offered practical ideas and examples about where to start.

The online discussion was organised by the Royal College of Physicians and looked at why it’s crucial to make changes to how we deliver outpatient services.

Dr Fluck described the introduction of a new model of care at his hospital Trust’s fracture clinic: “Face-to-face fracture clinics were completely overbooked with up to 120 patients in a morning clinic. Patients would wait a long time to be seen, long waits then for x-ray, then frustrated patients would be unhappy with their experience.

“The patient feedback from the fracture clinic was poor in relation to their environmental experience and their waits in clinic. This was made worse by the long waits for first appointment to be seen, which was 10 days at its height. This was then added to long waits for subsequent follow up appointments.

“We took patient experience and feedback and added this to our poor staff experience to engage our team in the benefits of a virtual fracture clinic (VFC). At the same time we engaged with the team in a new Consultant of the Week model of care for emergency pathways and this included the VFC as a part of the new role. This meant that clinicians were timetabled – dedicated time – to be the VFC Consultant every day. This intervention has transformed the experience for staff and patients”

The Royal College of Physicians is currently working with NHS England and NHS Improvement to support funded outpatients transformation pilot projects. They are exploring options for providing more general support. The RCP also has a role in working with NHS and other organisations at the national level to remove barriers to change.