The number of patients logged as ‘did not attend’ has always presented obstacles to the efficient management of outpatients departments. But now with waiting lists reaching record levels, as covid-19 cases steadily decrease across the country, more focus is needed on the reprioritisation of outpatients referral and management as we look to our covid-19 recovery plan.. In fact, right now around four in five people are on waiting lists for hospital appointments, rather than surgery. 

Of course, a few months ago freeing up hospital beds for those suffering with covid-19 was the sole focus. It was an important survival instinct to simply stay afloat. But now, it will be critical that more thought is given to ensuring patients in need of care are able to attend the right place, at the right time, to see the right specialist or clinician.

The challenge, however, will be in how outdated ways of managing patients are reformed to support outpatients departments in delivering a better quality of care, whilst giving patients the experience and support they deserve. . 

Queue loving Brits are a thing of the past

The first challenge we’ll need to overcome is our current queuing system. Waiting in line, whilst a fairly accurate stereotype associated with people in the UK, is one that needs a radical rethink  when it comes to public healthcare. To overcome the current outpatients’ backlog and provide better outpatient care, the system needs an overhaul. The system currently operates under a process that in many instances, offers appointments on a certain date and time, based on simply the order in which your referral from the GP is received. This method of operating is far from patient centred. In fact, the failure to offer out appointments in an order based on need and prioritisation, is having a negative impact on the NHS and ultimately the health of the country . 

Correcting the broken patient pathway

To better balance waiting lists and reduce the backlog, we need to revisit the  patient pathway to care  and normalise a virtual outpatient service.  For example, in giving patients more control over their own outpatients journey, from enabling them to send in information ahead of a visit, self refer dependent on symptoms and manage their appointment process online, the total number of visits needed to be made to the hospital can be reduced, purely through pre-booking tests and appointments with all relevant specialists before attendance to the hospital. 

Installing digital triage en masse will empower patients to take more control over their appointments beyond their initial referral to their required department. For the clinician, digitising every stage of the patient pathway like this will also help the trust to manage waiting lists by identifying and removing any unnecessary appointments. Patients who are discovered to need less urgent treatment can then be managed remotely, freeing up clinician time to treat those who are in urgent need.

Whilst only a starting point, taking these steps in digital innovation will future proof our NHS against further uncertainty and strain, ultimately saving the system, and its staff, in times of difficulty.   Dr Murray Ellender, CEO of eConsult and practicing GP