Source · Select Committees · Public Accounts Committee
Recommendation 2
2
Accepted
NHS England's outpatient transformation programme failed due to inadequate clinical engagement.
Conclusion
NHS England’s plans to transform outpatient services were not credible, even though it had already acknowledged that more efficient outpatient services would make a material difference to the waiting list. The outpatients transformation had aimed to free up capacity in outpatients services and NHS England had set a target to reduce follow- up outpatient appointments by 25% (compared to 2019–20 levels) by March
Government Response Summary
The government agreed and stated the recommendation is implemented, citing a published review of governance, integration of outpatient transformation work, and ambitious proposals in the Medium Term Planning framework to reduce unnecessary follow-ups and improve triage.
Government Response
Accepted
HM Government
Accepted
The government agrees with the Committee’s recommendation. Recommendation implemented DHSC and NHS England undertook a review of programme governance to ensure the right structures are in place to deliver the ERP, which was published in January 2025. This included integrating outpatient transformation work within the elective care programme into refreshed programme governance, as well as improved reporting on performance, programme delivery and outcome tracking to the Programme Board and relevant sub-groups. In order to deliver the commitment to improve the percentage of patients waiting no longer than 18-weeks from referral to treatment to 92% nationally by March 2029, it is essential to transform outpatient care. Outpatient care accounts for the majority of pathways on the elective waiting list, with 80% of elective pathways ending (for example through treatment or being discharged) in an outpatient setting (that is without an admission). That is why the Medium Term Planning framework (2026-27 to 2028-29) has set out ambitious proposals for the further use of Advice and Guidance (A&G) asking systems to ensure all referrals go through a single point of access, this delivers a more robust approach to triage, so patients are cared for closer to home and there are fewer outpatient appointments in secondary care. The framework requires a significant reduction in the number of clinically unnecessary follow-ups, which will be supported by Getting it Right First Time (GIRFT) and potential changes to payment for follow-up activity. This is part of a new model of planned care which will deliver the ambitions of the 10 Year Health Plan. Further details will be published in due course.