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What is the challenge your project is going to address and how does it connect to your chosen theme?

NHS England have set a challenge for CCGs and trust to work together to improve outpatient services and deliver system savings. North Central London (NCL) STP outpatient activity and referral rates are high when compared to benchmark (NCL vs England):

Patients referred to outpatient clinics expect to be seen by a doctor. To achieve the NCL STP trajectory of reducing 30% of outpatient appointments over the next 5 years will require significant changes to the model of delivery of outpatient services. Group consultations, straight to test, virtual reviews, etc. will become the norm. Exiting patients with long term conditions will no longer  automatically have an annual check up, monitoring may be virtual or in primary care based on risk stratification. This project will work with patients and clinicians across CCGs and trusts in NCL to explore how to change expectations and prepare the local population for these new ways of delivering services.

What does your project aim to achieve?

The overarching aim of the project will is prepare patients, public and staff for ways of working over the next 2 years in order to achieve a 30% reduction in outpatients activity in the next 5 years.

The funding will be used for engagement and development of communication resources for use by providers and CCGs across NCL through existing patient and public groups to discuss changes to outpatients services and develop communication resources. New ways of providing outpatient services will be a reduce unnecessary appointments, releasing provider capacity and improving RTT performance.

The project will develop the narrative for the changes and tools to explain changes to patients. The project will explore patients concerns about the changes and be used to prepare staff to explain to long-term patients why follow up processes are changing.

The impact of the project will be measure though patient satisfaction processes, complains and comment from patients.

How will the project be delivered?

The project resource will use co production methods. Broadly, the delivery steps will be:

Agree with communication teams on how to work collaboratively going forward, building relationships and setting expectations of joint working
Structure a coherent narrative which will be a golden thread though all aspects of the project
Prioritise patient groups to engage with and provide examples of outpatient care for discussion
Identify the appropriate providers to engage with harder to reach groups
Agree implementation plans and timescales for engagement events
Agree methods for sharing learning and synthesising learning after events
Agree and implement time scales for development and delivery of communication tools
Fine tune the communication tools with patient groups
Share the resources
Risks will be managed through existing provider outpatient transformation boards.

Advice and expertise of Q members will be used to refine process and tailor our approach to delivering a successful project.

What and how is your project going to share learning throughout?

NCL has a very diverse patient population, which presents a challenge to all healthcare providers. The area incudes some of most and least deprived wards in England with a significant proportion of the population having English as a second language. Information for patients must explain service changes and address concerns in plain English so patients are prepared for, and accepting of, new ways of working.

The exploring patients concerns through engagement exercises will inform delivery of outpatient services. The learning and outputs from the project will be shared across NCL and more widely with peers. Sharing would be through Q online groups and Model Hospital Trust Ambassador Kahoots. The project would aim to publish results at the conclusion, either in journals or blogs/ Linkedin articles.

How you can contribute

  • Advice regarding the challenge of engaging with patients, public and colleagues when changing long established processes.

Plan timeline

5 Aug 2019 Information sharing agreement between organisations
28 Oct 2019 Project planning meetings ( multi agency)
25 Nov 2019 Arrange sessions with existing patients and public groups
3 Feb 2020 Patient and public engagement begins
6 Apr 2020 Collation of infromation and ideas, draft tools
4 May 2020 Consult on draft tools with patients and public
6 Jul 2020 Ratification and adoption of information tools


  1. Can you explain 'Model Hospital Trust Ambassador Kahoots' please.

  2. I do like your idea but can you tell me who is currently responsible for the deign of outpatient services? I have been doing some work in this area and would be keen to help.

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