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Rebuilding the NHS - Resetting outpatient services for the 21st century in the context of COVID-19

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Royal College of Physicians (RCP) and the Royal College of General Practitioners (RCGP) set out principles and recommendations for the reset of outpatient services.

The COVID-19 pandemic has meant rapid and significant change. We have had to change how we treat patients, and patients have changed how they seek healthcare. Although the full picture is far from clear, the pandemic has demonstrated that the NHS can adapt quickly.  

It presents us with the opportunity to reset outpatient services. In doing so, we must not be constrained by our current concept of ‘outpatients’. Instead we need to think simply, in terms of how patients can be best supported by primary and secondary care working collaboratively. 

In this document, the Royal College of Physicians (RCP) and the Royal College of General Practitioners (RCGP) set out principles and recommendations for the reset. We hope they will help integrated care systems and/or the organisations that comprise them. 

In summary, we recommend that they should: 

  • make sure that all relevant organisations, patients and carers are involved in the production and implementation of reset plans 

  • systematically consider the impact of their reset plans on inequality 

  • work towards a system in which patient records are available to everyone involved in decision making and provision of care 

  • design new clinical processes to maximise the benefit of new technology to patients, carers and clinicians 

  • make sure that everyone involved has access to the education, training and support they need to adapt to and use new systems. 

Financial reform is crucial to the success of these efforts. We recommend that the NHS introduces a blended payment model to encourage the changes that are needed.