The modern outpatient: a collaborative approach 2017-2020

2. Key Facts

2.1 NHSScotland delivers almost 5 million outpatient appointments every year. Patients attend outpatient appointments for one of three broad reasons:

• an initial referral to acute care to get more specialist opinion and diagnosis;
• for treatment, which may be a series of treatments over time; or
• for follow-up to check on outcomes and/or continuing symptoms.

During 2015/16 there were a total of 4,500,280 outpatient attendances, of which 1,486,522 were new and 3,013,728 were return appointments.

Return appointments accounted for 67% of all acute outpatient activity (see Annex 1).

2.2 During the period 2007/08 to 2015/16:

There has been an 8% increase in new outpatient attendances to all specialties (excluding A&E), (see Annex 2).

Some high volume specialties have experienced significant growth in new attendances:

2.3 Some high volume specialties have experienced significant growth in all attendances (new and return):

2.4 GPs workload has also grown in both volume and complexity with 24.2 million consultations taking place on an annual basis. GP consultation rates have increased by 11% over the last 10 years.

Redesign in action: Redesign which delivers results

Sustained service redesign which addresses the management of both new and return patients has reversed the growth trends in appointments. Fracture Pathway Redesign and the development of Musculoskeletal ( MSK) services are having a positive impact in off-setting potential growth. Trauma and Orthopaedics new and return appointments have reduced by 15% since 2007/8 through clinically-led redesign of pathways