A south-west London outpatient transformation group worked with the James Lind Alliance – independent experts in developing partnerships to set health research priorities – to choose the top ten issues for outpatient research identified by patients, carers, managers and health professionals across the UK, working through over 1,500 possible questions. 

The steering group for the priority setting partnership (PSP) included Rashmi Kumar, the ARC’s Involvement Advisory Group chair and a public member on the ARC's Executive and Board, and Natasha Curran, the ARC’s implementation and involvement team lead, Medical Director at the Health Innovation Network South London. Patient representatives included Margaret Ogden and Clive Moore-Ceaton, who are both involved in ARC South London’s research. 

Through the PSP, 1,575 questions for research on the delivery of outpatient services were submitted and prioritised from across the UK. Eight themes over 21 questions were identified. These were then presented at a workshop involving patients, carers, healthcare professionals and administrative staff to inform the prioritisation of the final top ten questions for researchers. 

There was a wonderful mix of patients, carers and clinicians in the workshop. Everyone felt involved and felt able to share their experiences and priorities

Rashmi Kumar

Rashmi Kumar, patient representative

This true partnership working to identify what really matters to patients, carers and clinicians – without assumption or predetermination, represents a ground-breaking data insight into what NHS organisations need to prioritise for transformations to deliver value to patients, staff and taxpayers alike

James Friend, Director of Digital Strategy, NHS England – London Region

Top 10 research priorities identified: 

  1. How could all necessary tests and relevant medical history be identified and completed before the outpatient appointment? 
  2. What are the most effective ways to decrease the time gap between an investigation (eg a biopsy) and sharing the results/next steps with patients? 
  3. How can patients be more involved in decisions regarding their care and treatment and be empowered to ask questions during consultations and ensure they understand and give their opinion? 
  4. What are the best ways of deciding which types of health conditions and patients can safely and effectively be managed virtually versus face-toface? 
  5. How can technology be best used to support patients, carers, managerial/administrative staff, and healthcare professionals in improving the patients’ care pathway and capacity of outpatient services? 
  6. What are the best ways to deliver information to patients about their conditions, management plans, tests to be done and results: verbal and/or written methods? 
  7. What are the best ways to improve the outpatient experience and outcomes for patients with specific needs (eg autistic patients, prisoners and homeless people)? 
  8. What are the best ways to create a comfortable and less stressful environment in outpatient clinics for patients, carers, and their families while waiting for their appointments? 
  9. Can hub models improve waiting time and accessibility for diagnostic procedures and how? Is it better to have tests done in one place, same day? 
  10. For patients with multiple health conditions that are connected to each other, should these be separate appointments, or all appointments combined?

We hope that this process will inform future national research strategies and funding to ensure that outpatient transformation addresses the themes highlighted from the PSP. This work could not have been completed without the steering group and everyone who contributed to the PSP and shared their views

Caroline Hing, Clinical Director of Corporate Outpatients at St George’s University Hospitals NHS Foundation Trust

Find out more

About the James Lind Alliance 

The James Lind Alliance (JLA) is a UK-based non-profit making initiative, established in 2004. They bring patients, carers and clinicians together to identify and prioritise unanswered questions or evidence uncertainties that they agree are the most important. 

A priority setting partnership (PSP) with the JLA is a well-recognised way to ensure the voices of patients, carers, clinicians, healthcare professionals, managerial and administrative staff are all heard across primary care (GPs) and secondary care (hospitals).