Source · Select Committees · Public Accounts Committee
Recommendation 23
23
Accepted
Clinical engagement for outpatient transformation proved challenging, failing to gain support for targets.
Conclusion
NHS England (NHSE) engaged clinicians on the transformation programmes in various ways including working with representative bodies and embedding National Clinical Directors within the programmes to provide medical leadership. The surgical transformation programme benefited from in-person engagement and support from the Royal College of Surgeons of England.50 On the diagnostics programme an independent review gave proposed changes credibility. However, clinical engagement on the outpatients programme, which involves a much wider range of clinical specialities, was significantly more challenging. The NAO report notes that local NHS systems accepted outpatients services could be improved but did not agree that reducing follow-up appointments was the right solution, and NHSE failed to get support from the Royal College of Physicians for the target to reduce follow-up appointments.51
Government Response Summary
The government agrees that securing clinical support is essential for successful outpatient transformation and is strengthening clinical engagement with the aim of delivering outpatient care remotely or in community settings by March 2026.
Government Response
Accepted
HM Government
Accepted
5.1 The government agrees with the Committee’s recommendation. Target implementation date: March 2026 5.2 Securing clinical support, including royal colleges and specialist societies, is essential 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. 5.3 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. 5.4 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.