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John Hadley (national clinical lead for Outpatient Get It Right First Time (GIRFT) a clinically led programme helping to improve the quality of care within the NHS, and Consultant Surgeon at ASPH) explains why this is an important programme:

“In 2017/18 the NHS spent £11 billion on 93.5 million outpatient appointments and treatments. Nationally there is a 6% growth in outpatient activity each year, mostly due to increases in new referrals. This increased activity has largely been absorbed by the system with little investment. At the same time Did Not Attend (DNA) rates are increasing. In the last couple of years DNA rates have been exceeded by hospitals’ cancelling patients’ appointments.

So we are not making good use of the slots we have in our outpatient clinics at the moment. In addition to this;

  • Nationally, 25% of doctors say that up to 20% of their patients do not need to come to an outpatient clinic at all.
  • 5% of road traffic in England is deemed to be NHS-related, contributing to pollution and traffic congestion.
  • HMRC have calculated that every hour of the average adult’s time costs £17 to society, so three hours of a patient’s time (travel, parking, and appointment) costs our society £51.

We must accept the reality that the current model of outpatients is no longer serving the needs of our patients, nor is it cost effective or sustainable for the tax payer and the NHS in the long term. The need for change is well made and recognised as a central theme in the recently published NHS Long Term Plan and is the impetus for launching the ASPH Outpatient Transformation Programme.“



ASPH has established a Steering Group to oversee projects seeking to improve the experience of patients when they have an outpatient contact with us and improve capacity and productivity of outpatient services across all specialties and thus deliver best outcomes and biggest impact on our outpatient services.

We would like to see ASPH as a leader in this process and hope for the support and enthusiasm of all staff and patients in making this change a reality.