Key recommendations

1. Quality improvement projects should report on value as a whole, recognising the population and system effects of change as well as individual clinical outcomes.
2. Trusts should be remunerated on the basis of clinical value, not units of physical interaction or activity.
3. National guidance for the oversight of outpatients as part of local governance structures should be developed and integrated in all trusts alongside mortality and morbidity reviews.
4. Specialist organisations and charities should work collaboratively to oversee the development of signposting to resources that support outpatient consultations, eg patient decision aids, preventing duplication of efforts locally.
5. NHS leaders and local government need to provide clear and structured guidance on how to build partnerships with the voluntary and community sectors. This should be created and supported by case studies.