A new report from the Royal College of Physicians (RCP) and the Patients Association sets out a vision to reform planned specialist care over the next 10 years.
‘Outpatient care’ is the part of the NHS where patients receive planned, specialist care without the need for a hospital stay. It is the second most used NHS service in a patient's lifetime – in 2023/24, there were over 135 million outpatient appointments – yet it is associated with delays, poor communication and confusion caused by trying to navigate services.
Following extensive engagement with patients, healthcare professionals and NHS England, the RCP – in partnership with the Patients Association – has set out a vision to transform planned specialist care over the next decade, stating that it is currently inefficient and not fit for purpose.
The RCP emphasises that outpatient reform must be part of the government’s 10-year plan, providing the necessary funding and resource so it works better for patients and clinicians.
The need for care through outpatient services is predicted to grow as the population ages and more people live with multiple health conditions. A patient with four or more health conditions will need more than three times as many outpatient appointments as someone with only one health condition. With almost one in five (17%) people over the age of 65 expected to live with four or more long-term health conditions by 2035, reforming outpatient care must be a priority.
The report describes the significant cultural shift needed to move outpatient care away from appointments as the single way to deliver care, towards an approach that enhances cross-system and multidisciplinary working.
The RCP vision sets out five ambitions for outpatient care:
- provide timely care by the right person, in the right setting
- empower patients through personalised care and self-management
- improve communication across professionals and with patients
- use innovative models of care to avoid unnecessary appointments
- harness data and technology to reduce inequalities and prioritise need.
To deliver these ambitions, we must innovate and transform the way outpatient care is delivered in the UK. The RCP’s new report redefines the full scope of NHS planned specialist care, describing eight transformational shifts in how it is delivered – including moving from a ‘one size fits all’ approach to personalised care; from siloed teams to integrated pathways; and from activity-counting to outcome-focused care – underpinned by five enablers:
- digital tools and technology
- education and training
- coding and data
- commissioning and funding models
- workforce.
The report makes over 40 recommendations for system leaders, healthcare providers and commissioners, specialist societies, clinicians and patients. If implemented, these recommendations will foster a patient-centred, holistic approach to outpatient care, where preventative medicine, flexible diagnostic pathways and integrated services work together to enhance patient experience and outcomes.
This vision will only be possible with a capable, empowered and expanded workforce, enabling new models of care to thrive. In a 2025 snapshot survey of RCP members, more than two-thirds (66.8%) of physicians said their ability to deliver outpatient care was limited by the availability of rooms, while fewer than a third (31.2%) of respondents said they have the time and information needed to prioritise patients on follow-up waitlists based on their risk.
There must be adequate administrative support and digital infrastructure for clinicians, so they can work at the top of their licence and maximise their time. The RCP will continue to call on the government to deliver the planned expansion of medical school places, along with the increased supervisor capacity and a commensurate increase in postgraduate training places.
Download the full report below.