An outpatient appointment is one which is currently delivered in a hospital setting, but where the patient does not require an overnight stay. We know that around 40-50% of outpatient appointments in Stockport result in advice and/or pharmaceutical treatment only (i.e. being prescribed medication to treat the problem).

It has been recognised that we could develop a series of different approaches to deliver more effective care outside of the hospital, particularly using technology to help strengthen communications, advice and treatment between patients, GPs and specialists.

This business case proposes changes to the way outpatient care is delivered. It recognises which parts of the health and care system are affected by, or have an effect on outpatient care.

The success of this business case will depend on people feeling confident and supported to manage their own health; having access to specialist advice, guidance and routine investigations; diagnostics being available in the most appropriate setting; and importantly people being seen by the right person in the right setting depending on their need.

It proposes changing the way outpatient appointments are delivered, and focuses on six key priorities to provide:

  1. Active support for people to take more control of their own conditions, including decision making and the provision of advice
  2. Support for GPs in clinical decision making
  3. Appropriate clinical triage of referrals and investigations
  4. Alternatives to traditional appointments and support to discharge people from outpatient clinics
  5. Identifying outpatient appointments that no longer need to happen
  6. Co-ordinating support for people who have complex conditions

This business case aims to improve patient care by providing support, information and advice through improved technology and access to community resources. This will help people to be more confident in managing their own care.

Particular focus would be given to educating and developing GPs, practice staff and other community health professionals so that they are more aware of local services. This would ensure that local people are given advice about patient support which will be more appropriately accessed. This will be particularly beneficial for those people with long-term conditions.

Communication channels between GPs and specialists will be developed and improved to allow health and social care professionals to exchange information more easily.

Developing a consistent approach to triaging referrals will mean that:

  • Patients are seen in the right setting by the most appropriate health professional, avoiding wasted appointments
  • Advice and guidance can be provided to the GP to ensure that people can be managed in the community wherever appropriate, reducing the need for unnecessary hospital appointments
  • Required investigations are carried out and reviewed before an appointment
  • Only those patients that require a specialist to be involved in their care are required to physically visit a hospital

The ultimate aim is to reduce unnecessary referral and follow-up appointments for people, by identifying which outpatient activity can be stopped. Wherever possible, non-face to face clinics will be provided for people that do not need to see their healthcare professional, and community specialist nurse capacity will be utilised to enable and support more effective outpatient appointments.