Improving the Outpatient experience: Patient feedback from deliberative engagement workshops

Led by Brighton & Hove, the three Healthwatch delivered a programme of four themed workshops, each covering one of the areas of focus for transformation of outpatient services. The same 31 diverse participants from across Sussex attended each workshop, representing people who had attended an outpatient appointment and those on an outpatient waiting list, and shared their views on the proposals.

Workshops followed a deliberative engagement methodology focused on increasing participant knowledge of the outpatient system and enabling them to make an informed judgement of the transformation options proposed.

What we heard on Outpatient transformation

The purpose of the workshops was to review four proposed initiatives to transform the outpatient experience, as part of NHS England’s Outpatient Recovery and Transformation Programme. The headlines proposals and feedback included:

• Advice and Guidance (A&G): This enables GPs to seek advice and guidance from consultants about diagnosis and treatment, with the potential that the patient need not visit the hospital but be treated in the local community.

Participants thought Advice & Guidance made good sense in theory but were concerned that some conditions and some individuals were not suitable for this system.

• Utilising system capacity inclusive of Patient Choice (Patient Choice): This is where an alternative referral location could be offered to patients, which may enable them to see a consultant quicker. However, the provider offered may be in a variety of locations, sometimes outside of the local area.

Participants felt that Utilising System Capacity (Patient Choice) could help respond to local demand pressures. However, if the offer is further away than the patient’s local hospital, this may exclude some patient groups.

• Patient initiated follow-up (PIFU): After the initial consultant appointment, usually a patient would be given a follow-up appointment on a set date and time. Instead, PIFU gives the responsibility of follow-up to the patient, where they decide if and when they need an appointment. They are then expected to proactively telephone (using a number provided in advance) and make their own booking for a follow up appointment.

Participants felt Patient Initiated Follow-up (PIFU) was a good example of giving patients some control over their own healthcare journey. However, some patients would need additional support and for other patients, PIFU may not be suitable.

• Reducing ‘Did not attends’ (DNAs): DNAs are the name given to patients who do not turn up to appointments, costing the NHS time and money. NHS Sussex were interested in participants’ views about why this might happen and how to prevent this happening.

Participants disagreed with one another about patient responsibility around reducing Did Not Attends. Some participants felt that DNAs should go to the bottom of the waiting list. Other patients suggested that financial and deprivation reasons caused patients to DNA.

Our recommendations

The process generated 7 key recommendations, each aimed at supporting the Outpatients team at NHS Sussex to improve the outpatient experience. These included:

1. Involve patients in their care
2. Communicate with the patient throughout their journey
3. Ensure GPs are aware of and trained accordingly in all new healthcare initiatives
4. Take patients individual needs into consideration and adapt care, communication, and treatment accordingly
5. Ensure the infrastructure supports the transformation
6. Provide clear, concise patient information
7. Publicise the transformation widely and in accessible formats

Feedback from NHS Sussex

“We wanted to understand what matters to patients and how we need to adapt our programme accordingly. The discussions and points raised by all participants were of huge value to our programme plan going forward. Overall, the workshops and deliberative engagement process exceeded our expectations and we are incredibly grateful to everyone involved.”

Outpatient Transformation Team

Tell Us Your Experiences

If you have an experience of outpatient services in Sussex, then please share your experiences with your local Healthwatch via the contact details below. We want to hear your story.

Local Healthwatch can also support people with any health or care enquiry or feedback on any health or care services.

Healthwatch Brighton & Hove 
https://www.healthwatchbrightonandhove.co.uk/
Tel: 01273 234 040
Email: info@healthwatchbrightonandhove.co.uk 

Healthwatch East Sussex
https://www.healthwatcheastsussex.co.uk/
Tel: 0333 101 4007
Email: enquiries@healthwatcheastsussex.co.uk 

Healthwatch West Sussex
https://www.healthwatchwestsussex.co.uk/
Tel: 0300 012 0122
Email: helpdesk@healthwatchwestsussex.co.uk