Source · Select Committees · Public Accounts Committee
Recommendation 24
24
Accepted
NHSE struggled with clinical engagement for outpatients programme, delaying reset despite slow progress.
Recommendation
NHSE told us that it had struggled to get the clinical community uniformly behind the outpatients programme and that engagement had also been highly variable from specialty to specialty. We heard from the Department and NHSE that in their view the outpatients programme required extensive change to the way everyone in an acute hospital works, from clinicians to administration staff. The fundamental nature of these changes, we heard, meant that industrial action caused significant disruption to the ability of the programme to make progress at the operational level.52 NHSE told us that it had not applied all of the expertise available to them and accepted that it had not communicated the opportunity for change that it sees in the outpatients programme. The NAO report found that while NHSE recognised that progress towards outpatients targets had been slow by September 2022, it did not reset the programme until 2024.53 49 The Royal College of Radiologists (NWT0002); Royal College of Physicians (NWT0025); The Royal College of Ophthalmologists (NWT0032) 50 C&AG’s Report, paras 17, 4.9 51 C&AG’s Report, para 4.9 52 Q 45 53 C&AG’s Report, para 4.10 14
Government Response Summary
The government agrees and commits to strengthening clinical engagement to ensure clinicians are delivery partners in transforming planned care, aiming to deliver outpatient care remotely or in community settings, with a target implementation date of 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.