In partnership with the Patients Association, the Royal College of Physicians (RCP) has published a report into outpatient care across the NHS, concluding it is “no longer fit for purpose.”
‘Prescription for outpatients: reimagining planned specialist care’ sets out a vision for reformed patient care that puts the patient’s needs first, rather than the needs of the system.
The demand for care through outpatient services has grown year on year – a trend that is predicted to continue as the population ages and more people live with multiple health conditions. These trends have contributed to growing waiting lists, with the majority of people currently on NHS waiting lists in England needing an outpatient appointment rather than an operation.
Senior doctors are now advocating for a shift towards prevention and early intervention, timely care closer to home and flexible, multidisciplinary integrated care pathways working across the healthcare system. The RCP vision sets out five ambitions for outpatient care:
• Timely care by the right person, in the right setting
• Empower patients through personalised care
• Improve mechanisms for communication across professionals and with patients
• Use innovative models to make the most of time spent with patients
• Harness data and technology to reduce inequalities and prioritise need.
In a 2025 snapshot survey of RCP members, 57% said they did not have adequate resource to deliver outpatient activity remotely. More than two thirds (66.8%) of physicians said their ability to deliver outpatient care was limited by the availability of rooms, while fewer than a third (31.2%) of respondents said they have the time and information needed to prioritise patients on follow up waitlists based on their risk.
Time to get radical
Dr Theresa Barnes, RCP clinical lead for outpatients says: ”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.”
Outpatient care has historically been used to describe care delivery in a particular setting or location, where patients consult doctors who give specialist advice and treatments.
The RCP’s new report redefines the full extent of NHS outpatient, or planned specialist care, describing eight transformational shifts in the way it is delivered – including moving from a ‘one size fits all’ approach to personalised care; from siloed teams to integrated pathways; and from activity-counting to outcome-focused care – underpinned by five enablers:
• Digital tools and technology
• Education and training
• Coding and data
• Commissioning and funding models
• Workforce.
The RCP’s call for outpatient reform comes in direct response to Lord Darzi’s independent review of the health service. It urges the government to put outpatient reform at the centre of the 10-Year Health Plan, with the funding and resource to make the system work for patients and clinicians.
