‘No longer fit for purpose’: RCP unveils long-term vision to transform ‘disjointed and ineffective’ NHS outpatient care

The current model of outpatient care is outdated, inefficient, and in need of reform. Over 135 million outpatient appointments in 2023–24 were often 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 is now calling on the UK government to put outpatient reform at the centre of the 10-Year Health Plan, with the funding and resource to make the system work for patients and clinicians.   

Outpatient care is a vital part of the NHS, where patients will receive planned clinical investigations and tests, treatment and potentially life-changing diagnoses.  

The need for care through outpatient services has grown year on year – a trend that is predicted to continue as the population ages and more people live with multiple health conditions. These trends have contributed to growing waiting lists, with the majority of people currently on NHS waiting lists in England needing an outpatient appointment rather than an operation.  

Senior doctors are now advocating for a shift towards prevention and early intervention, timely care closer to home and flexible, multidisciplinary integrated care pathways working across the healthcare system. The RCP vision sets out five ambitions for outpatient care:  

• timely care by the right person, in the right setting 
• empower patients through personalised care  
• improve mechanisms for communication across professionals and with patients 
• use innovative models to make the most of time spent with patients  
• harness data and technology to reduce inequalities and prioritise need.  

In a 2025 snapshot survey of RCP members, 57% said they did not have adequate resource to deliver outpatient activity remotely. 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.   

Dr Theresa Barnes, RCP clinical lead for outpatients 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.   

‘Our new report, “Prescription for outpatients” draws on the ideas and expertise of doctors and patients to embrace a new way of doing things – prioritising people, rather than the system. We need a significant shift in the way we deliver planned specialist care. Getting this right is integral to bringing down NHS waiting lists and delivering the government’s three shifts. Now is the time to be radical.’  

Outpatient care has historically been used to describe care delivery in a particular setting or location, where patients consult doctors who give specialist advice and treatments.   

The RCP’s new report redefines the full extent of NHS outpatient, or planned specialist care, describing eight transformational shifts in the way 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: