Patient group appointments could boost NHS efficiency, doctors say

Patients should be offered group appointments to boost NHS efficiency, doctors have suggested.

A report by the Royal College of Physicians describes the current system of hospital outpatients as “archaic” and in need of “radical” reform.

The college issued its proposals, which also call for far more use of remote consultations, as the Government prepares to publish a 10-year plan on the future of the NHS.

Wes Streeting, the Health Secretary, has already said too many hospital check-ups are a “waste of time”.

The Royal College report, backed by the Patients’ Association, said the current system was not fit for purpose and called for alternatives, including appointments for multiple patients.

It said that instead of booking patients for individual follow-up appointments to advise on how to manage health conditions, sessions could instead take place in groups.

It also called for more use of “direct to test” pathways where diagnostic services are offered before seeing a specialist doctor, and for the introduction of polyclinics bringing multiple services together.

The report suggested that different types of models depended on the purpose of the appointment. Education about how to manage health conditions could be delivered by specialist nurses or pharmacists in group settings, it said, while group sessions might also be offered to patients with multiple health problems.

Clinicians were also urged to “actively consider whether care can be provided outside a traditional appointment in a hospital, such as through a remote consultation”.

And they were advised to “promote and implement novel outpatient pathways” including group care, remote monitoring and “direct to test” pathways, which mean tests occur before a specialist is seen.

The authors of the report said care must be transformed to give patients more “timely, productive and personalised care”.

Dr Theresa Barnes, the Royal College of Physicians clinical lead for outpatients, said: “NHS outpatient care is fundamentally no longer fit for purpose.

“It is archaic, disjointed and ultimately ineffective for both patients and staff. It has remained largely unchanged for decades, despite advances in technology.

“Most people on NHS waiting lists are waiting for an outpatient appointment, patient care is increasingly complex, and the medical workforce is frustrated and desperate for change.”

‘We need a significant shift’

The latest NHS figures for England show that an estimated 7.4 million treatments, relating to 6.24 million patients, were waiting to be carried out at the end of February. This is down from 7.43 million treatments and 6.25 million patients at the end of January.

Dr Barnes added: “Our new report draws on the ideas and expertise of doctors and patients to embrace a new way of doing things – prioritising people, rather than the system. We need a significant shift in the way we deliver planned specialist care.

“Getting this right is integral to bringing down NHS waiting lists and delivering the Government’s three shifts. Now is the time to be radical.”

Rachel Power, the chief executive of the Patients’ Association, added: “Too many patients tell us that outpatient care feels like an uphill battle, with delays, confusion, and a lack of joined-up communication that leaves them feeling powerless.

“Planned specialist care must be built around the needs of real people, not rigid systems.

A Department for Health and Social Care spokesman said: “Our 10-year health plan will fix the broken outpatient system – shifting more care to the community so patients can be seen in the right setting, and moving the NHS from analogue to digital to tackle poor communication and delays.

“We have already made progress on our mission to cut waiting lists – delivering an extra 3 million appointments and cutting the waiting list by 219,000 since July.”