Describing the current system as ‘not fit for purpose,’ the report responds directly to the challenges highlighted by Lord Ara Darzi in his 2024 independent review of the NHS in England.
RCP clinical lead for outpatients and consultant rheumatologist Dr Theresa Barnes describes the current model as ‘archaic, disjointed and ultimately ineffective for both patients and staff,’ noting that ‘outpatient care has remained largely unchanged for decades, despite advances in technology.’
‘Outpatient care is more than appointments,’ she adds.
‘We need to define the purpose of each interaction – what we want to achieve, and how best to do it, whether through virtual clinics or asynchronous communication with patients.’ However, she also pointed to systemic barriers: ‘currently, commissioning and job planning still count appointments – not outcomes. We need to incentivise new models of care that deliver results, even if the work is done differently.’
With over 40 recommendations for clinicians, patients, policymakers, and healthcare providers, the report outlines a comprehensive roadmap for change. It calls for a fundamental shift – from siloed teams to integrated models of care, and from complex, hard-to-navigate systems to simplified, accessible and personalised care pathways delivered closer to home.
In the report, the government is urged to put outpatient reform at the heart of its 10-year health plan. This vision for reform has the potential to transform the way services are delivered by:
- ensuring timely care from the right professional in the right setting
- empowering patients through personalised care and shared decision-making
- improving communication between clinicians and with patients
- using innovative models to make the most of every interaction
- harnessing data and technology to reduce health inequalities and target care where it’s most needed.
The report attracted immediate media attention, with coverage in The Telegraph, Independent and Mail Online – highlighting strong public interest in reforming this essential aspect of NHS care.
Developing the report
Work on the report began in 2023 with a series of summits held by the RCP, the Patients Association, and NHS England to explore current challenges and future opportunities in outpatient care. More than 250 individuals and 110 organisations contributed to this process, sharing their insights and experiences.
In 2024, the RCP convened a writing group led by Dr Theresa Barnes to develop the report. The group – comprising Dr Fiona McKevitt, Dr Tanya Bleiker, Dr Anne Kinderlerer and Sarah Tilsed – set out to capture the realities of outpatient care from patient, clinician, and system perspectives – and craft a new vision for services that meet the needs of today’s population.
Dr Fiona McKevitt, consultant neurologist at Sheffield Teaching Hospitals and outpatients clinical lead for NHS England, emphasises the critical role of communication in safe, effective care, explaining that:
‘Good care depends on smooth information transfer between professionals. It improves outcomes, reduces errors, and minimises treatment delays.'
Hospital-to-community shift: RCP workshop
In April 2025, the RCP hosted a major workshop bringing together physicians, patients, primary care leaders, and government representatives to explore the role of outpatient reform in the shift from hospital-based to community care. Topics included hospital-at-home models, advanced illness management, and the evolving role of physicians in neighbourhood care.
Workshop participants – including patients and resident doctors – discussed how to implement innovative care models, the new skills clinicians will need, and how best to support patients in the community.
‘Patients should see the right person first time, for early diagnosis and the best outcomes. Every encounter should count. Too often, appointments offer little benefit. We need to rethink how we add value to patient care.’
Says Dr Tanya Bleiker, dermatology consultant at University Hospitals of Derby and Burton, who spoke virtually at the workshop about the importance of value-based care.
Sarah Tilsed, head of partnerships and involvement at the Patients Association emphasised the need for person-centred care:
‘Patients must feel empowered to take an active role in managing their health. Personalised care, shared decisions, and self-management support can ease pressure on services and improve health outcomes.’
And what about the urgent need for better data integration? Dr Anne Kinderlerer, RCP digital health clinical lead and chair of unplanned care at Kingston Hospital agrees:
‘Clinicians managing chronic disease need longitudinal data across systems. Interoperable records and better coding can unlock the potential for AI to identify risk and direct care to those who need it most.’
Feedback from this workshop will inform future RCP policy and advocacy.
Looking ahead
The RCP and Patients Association hope this report will catalyse long-overdue reform in outpatient services – ensuring that care is timely, effective, personalised, and delivered where patients need it most. As momentum builds, the voices of patients and clinicians must remain central to shaping what comes next.
This article was produced for the June 2025 edition of Commentary magazine. You can download a plain-text PDF of this interview.