NHS Outpatient Care No Longer Fit for Purpose, Says Royal College of Physicians

The report said outpatients are subjected long waits to receive a diagnosis or treatment, poor communication, and difficulty in trying to navigate services.

A general view of staff on a NHS hospital ward at Ealing Hospital in London, on Jan. 18, 2023. Jeff Moore/PA Wire

The NHS’s outpatient care services are “no longer fit for purpose” and need reform, the Royal College of Physicians (RCP) has said.

A new report by the RCP and the Patients Association published on Wednesday found that the current model of outpatient care is outdated and inefficient, often resulting in “low-value” appointments.

Outpatient care typically describes care where patients engage with specialist medics to receive planned tests, diagnoses, and treatment. The report said that the current approach “too often results in poor patient and clinician experience.”

According to the report, outpatients are subjected to long waits to receive a diagnosis or treatment, poor communication, and difficulty and confusion in trying to navigate services. It also said that follow-up appointments are not always aligned to patients’ needs.

Rachel Power, chief executive of the Patients Association, said:  “‘Too many patients tell us that outpatient care feels like an uphill battle, with delays, confusion, and a lack of joined-up communication that leaves them feeling powerless.

“Our joint report with the Royal College of Physicians marks an important step towards the kind of reform patients have long been calling for. Planned specialist care must be built around the needs of real people, not rigid systems.”

Archaic, Disjointed, Ineffective

The report comes in response to Lord Ara Darzi’s review of the NHS, which highlighted the rise in waiting lists for planned care.

According to the British Medical Association’s (BMA’s) analysis of NHS data, in February 2025, there were 7.4 million treatments waiting to be conducted relating to 6.24 million patients. Around 194,000 of these people have been waiting over 12 months for treatment, a decrease from approximately 199,000 from February.

The BMA calculated the median waiting time for patients waiting to start treatment was 14.2 weeks, observing this to be a “significant increase” on the 7.5 weeks from February 2020, in the pre-COVID-19 pandemic era.

Dr. Theresa Barnes, clinical lead for outpatients at the RCP, said: “NHS outpatient care is fundamentally no longer fit for purpose. It is archaic, disjointed and ultimately ineffective for both patients and staff.

“It has remained largely unchanged for decades, despite advances in technology. Most people on NHS waiting lists are waiting for an outpatient appointment, patient care is increasingly complex, and the medical workforce is frustrated and desperate for change.”

10-Year Health Plan

Both the RCP and the Patients Association have called on the government to make outpatient reform central to their 10-Year Health Plan.

The government’s 10-Year Health Plan aims to reform the health service by creating more access to care in the community, improving GP access, offering more preventative care, and making better use of digital services, such as online consultations.

The RCP says any reform of health and social care must also consider the changing needs of patients. By 2035, nearly one in five people over the age of 65 are expected to be living with four or more long-term health conditions, suggesting demand for outpatient services will continue to rise.

The RCP says senior doctors are calling for a shift towards prevention and early intervention, along with more timely care that is flexible and delivered closer to where patients live.

Guys and St. Thomas's Hospital in London, on Oct. 14, 2011. Georgie Gillard/PA Wire

A Department for Health and Social Care spokesperson told The Epoch Times by email: “Our 10 Year Health Plan will fix the broken outpatient system—shifting more care to the community so patients can be seen in the right setting, and moving the NHS from analogue to digital to tackle poor communication and delays.

“We have already made progress on our mission to cut waiting lists—delivering an extra 3 million appointments and cutting the waiting list by 219,000 since July.”

NHS England Axed

One major change that the government has already initiated in its reform of health services is to axe NHS England, bringing its functions back under government control.

Prime Minister Sir Keir Starmer announced last month that his government would dismantle the arms-length body in a bid to cut costs. Ministers expect that savings from the restructure will go to frontline health care services.

Last week, Health Secretary Wes Streeting said it could take two years to dismantle NHS England—described by the government as the largest quango in the world—and acknowledged that the cost of redundancy packages could hit £1 billion.

The shakeup comes after Darzi published his comprehensive review of the NHS in September, where he said that the publicly-funded health service had to make improvements in productivity and efficiency.

The report detailed that despite record levels of funding, the health service was facing significant challenges, including cancer care in the UK falling behind other countries, waiting times for hospital procedures ballooning in 15 years, and waiting times at A&E causing thousands of extra deaths annually.