Gloucestershire Outpatients Transformation Programme


Gloucestershire Integrated Care System

Implementation of Outpatient Transformation Programme


Attain was commissioned by Gloucestershire Integrated Care System to develop and implement a refreshed Outpatients Transformation Programme across 4 specialties – Dermatology, Rheumatology, Diabetes and Neurology – and to develop an ICS-wide Outpatients’ Services Strategy.

The ambition was twofold; to use the integrated outpatient strategy to define the system ambition for outpatient services so that organisational priorities could be aligned and agreed, and to address phase one of outpatient improvement at pace, developing a blueprint for replication across other specialties. Core objectives included;

  • to deliver a better patient and staff experience and improved value for money through a collaborative approach
  • development of new models of outpatient care as a strategic driver for the ICS to rebalance the provision of services and resources between primary and secondary care, including changes to the medical workforce
  • with our support, Gloucestershire ICS wanted to develop an ambitious but achievable programme in line with the Long-Term Plan objectives which included reducing face to face appointments by 30%.

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What we did

  • Through the partnership, we developed a methodology for change working closely with clinical teams to identify problems and the interventions to solve them
  • We brought external objectivity providing positive challenge to the status quo, additional specialist capacity to kick start the process and gain momentum, working with our partners to embed a culture of continuous improvement through rolling out and sharing learning from the project
  • Change was managed through a mix of methodologies, using an agile approach to test solutions and learn from the outcomes before applying to a wider context
  • All interventions were developed with clinical teams and tested back with them before delivery as it was vital that patients, staff and clinicians sat at the heart of the process.  The output was a stratified set of speciality specific solutions with metrics to quantify benefits.

Our impact

  • The key areas of impact were: Improving key performance across outpatient specialties; redesigning services to improve care delivery and embedding a culture of continuous improvement into business as usual. Specifically –
  • The impact for patients included; reduction in complaints; improved communication with clearer and more timely information and improved patient engagement and decision making
  • The financial impact included; workforce review gained estimated 5% in activity across specialities; direct access for CT/MRI scans planned to reduce duplication by a projected 50% and saving time and resource through integrated training and education
  • The strategic and cultural benefits included; development of a system wide ICS Outpatient Strategy with aligned incentives and implementation plan; improved long term sustainability of clinical services through a more integrated workforce and embedded a culture of continuous improvement as BAU

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