Source · Select Committees · Public Accounts Committee
Recommendation 25
25
Accepted
NHSE working to improve clinical engagement for outpatients, but the fundamental care model requires change.
Recommendation
NHSE accepted that any reform or change management programme cannot work without clinical engagement, and told us that it was now carrying out a range of activities to secure clinical support for the outpatients programme. NHSE explained that, among other measures, it was providing access to performance data at a local level, embedding clinical oversight at the regional level and having two national clinical directors involved in the programme at a national level.54 The NAO report suggests that there are signs that NHSE is now achieving better engagement on outpatients transformation.55 However, we heard that the model for outpatient care is the same one that has been in place for decades and that the whole model needs to change.56 The Department’s approach to making major changes
Government Response Summary
DHSC and NHS England are strengthening clinical engagement and ensuring clinicians are delivery partners in transforming planned care. They 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.
Government Response
Accepted
HM Government
Accepted
5. PAC conclusion: NHS England’s performance to date has not demonstrated that it can secure the clinical engagement that will be necessary to transform waiting lists. 5. PAC 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. 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.