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Friday, 09 November 2018

NHS chief urges more tech use to avoid unnecessary outpatient appointments

Written by Jennifer Cockerell

England's top doctor has called on the NHS to use more technology and innovation to reduce the thousands of unnecessary outpatient appointments carried out every day.

NHS England medical director Professor Stephen Powis said health leaders should embrace technology such as Skype, apps and online tools so patients can avoid hospital visits and time off work and school -while also saving the NHS millions.

He said many of the 118 million outpatient appointments that take place every year are unnecessary.

The NHS has evolved and innovated to meet the changing needs of patients over the past 70 years, but it is "crucial" that it now looks at how it interacts with patients so it continues to provide the best possible care, he said.

In his foreword to a report on outpatient care by the Royal College of Physicians (RCP), he said: "The outpatient system is older than the NHS and the time has come to grasp the nettle and use tech and other innovations to improve patients' experience and care.

"As part of the long-term plan for the NHS, it's right we look at ways to cut unnecessary appointments, save thousands of journeys, reduce traffic and pollution and make the NHS more efficient."

The report suggests outpatient appointments should become more patient-centred, meaning there should be a clear health benefit when asking people to travel to appointments and take time off work and school.

Transport to and from outpatient clinics has an impact on the environment, and in turn on public health, it points out, with 5% of UK traffic each day NHS-related.

Ending unnecessary appointments will also mean patients do not have to pay for travel or childcare, while it will free up clinical specialists to spend more time with complex patients, the report suggests.

It said outpatient appointments account for 85% of hospital activity, excluding A&E, and demand for appointments is outstripping the growth of the UK population.

Outpatient appointments in England have doubled over the last decade to 118 million a year, but one in five potential appointments is cancelled or reported as "did not attend", with the majority of cancellations instigated by the hospital.

A survey of doctors by the RCP found a quarter said up to 20% of their new patients did not need to come to outpatients.

Prof Powis added: "For many people, care can be delivered more timely and conveniently closer to home, by specialists at the GP surgery or by using technology in new and exciting ways.

"This report shows a snapshot of exciting new models already working successfully through apps, Skype, text messaging and remote monitoring systems that are changing the shape of care. We need to bottle and spread those examples building a new consensus for the future based on the views of clinicians and patients."

The report's co-author, Dr Toby Hillman, clinical lead for the RCP Sustainability Programme and a consultant respiratory physician, said: "We must recognise the public as individuals with varying health needs, personal pressures and ability to manage their own treatment, and give them more control over when and how they receive care.

"Having re-evaluated the purpose of outpatient care and aligned its objectives with modern-day living and expectations, we must ensure that the benefits are measured in terms of long-term value for patients, the population and the environment, not just short-term financial savings."

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