Source · Select Committees · Public Accounts Committee
Recommendation 5
5
Acknowledged
Require the Department to set out new plans for securing clinical engagement on outpatient transformation.
Recommendation
NHS England’s performance to date has not demonstrated that it can secure the clinical engagement that will be necessary to transform waiting lists. Clinical engagement has worked best when there been close working between national and local clinical leaders, and specific and expert support between peers. The diagnostic transformation programme and the surgical transformation programme benefitted from clinical leadership and the support of relevant Royal Colleges. NHS England recognises that this is central to securing change and acknowledged that it still has to work out how it can get better clinical engagement, particularly for the outpatients programme. While NHS England has now set new incentives and priorities, the scale of engagement necessary to achieve full clinical support for the outpatients programme remains a significant challenge. Some progress has been demonstrated by NHS England through other outpatients programmes such as the Further Faster 20 programme to reduce long-term economic inactivity, although formal evaluation of the programme by NHS England and the Department has not yet been completed. 4 recommendation The Department should set out what it plans to do differently to secure clinical engagement on the outpatients transformation programme to improve waiting times.
Government Response Summary
The government agrees and states it is strengthening clinical engagement, referencing existing plans and recent engagement events with clinicians, but does not outline specific new actions it will take to secure engagement differently for the outpatients transformation programme.
Government Response
Acknowledged
HM Government
Acknowledged
The government agrees with the Committee’s recommendation. for successful outpatient transformation and has been the main challenge in previous transformation efforts. DHSC and NHS England are strengthening clinical engagement and ensuring clinicians are delivery partners in transforming planned care, as set out in the Elective Reform Plan, 10 Year Health Plan and Medium-Term Planning Framework. This transformation will deliver significant elements of outpatient care remotely or in community settings. This ambition aligns with the Royal College of Physicians’ Prescription for Outpatients report, published in April 2025. This engagement will strengthen the evidence base for reforms, foster broad clinical endorsement, and identify and resolve barriers to implementation. NHS England and DHSC have already begun engaging with clinicians to secure their support, holding a ministerial launch event at Downing Street and a summit on Urgent and Emergency Care and Outpatients, hosted by the Royal College of Surgeons. At these events Royal College leaders and National Clinical Directors of several medical and surgical specialties pledged their support with delivering transformed planned care. This is critical to delivery. DHSC and NHS England will continue to use existing forums with Royal Colleges and Getting It Right First-Time specialty leads to test delivery, attend national specialty events and webinars to reach a wider set of clinicians and set up new forums as appropriate to work more closely with frontline clinical staff. billion by the end of the Spending Review period (2029-30), to invest in the NHS and wider health infrastructure. 6.4 DHSC has worked closely with Treasury to ensure that plans for merging NHSE and DHSC are affordable and deliverable, with the Autumn Budget 2025 announcing £860 million of funding reprofiled from later to earlier years to support ICB and organisational integration, while maintaining the overall RDEL envelope over the SR25 period. The merger of NHS England into DHSC provides an opportunity to strengthen accountability and align strategic financial planning with delivery of the 10-Year Health Plan. 6.5 Announcements from the department, and at the Autumn Budget, support the core ambitions of the 10-Year Health Plan. The government will aim to ensure that announcements are accompanied by a clear plan for delivery and affordability wherever possible and appropriate, recognising that detailed funding arrangements cannot always be made publicly available at the time of announcement.