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National

Dashboard > Outpatient Appointments


 

Outpatient appointments per 100,000 population 8652.36
Opportunity £385,974,594
Volume Opportunity 2,558M
Rank 1

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Treatment Function Outpatient appointments per 100,000 population Financial Opportunity Volume Opportunity Rank
Trauma & Orthopaedics 1141.61 £31,988,055 236,239 1
Cardiology 513.69 £23,645,956 131,868 1
Gynaecology 609.10 £19,218,654 129,548 1
Diagnostic Imaging 562.06 £18,716,151 302,846 1
Ophthalmology 751.99 £18,164,108 159,020 1
General Surgery 353.02 £17,474,603 108,663 1
Paediatrics 305.30 £17,079,353 77,366 1
Urology 354.25 £12,854,246 69,301 1
Ear, Nose & Throat (ENT) 537.68 £12,810,324 113,931 1
Gastroenterology 248.68 £12,288,060 61,971 1
General Medicine 146.65 £11,906,385 63,338 1
Breast Surgery 255.54 £11,156,175 58,009 1
Dermatology 440.78 £10,867,127 95,150 1
Respiratory Medicine (Thoracic Medicine) 221.86 £10,591,635 55,661 1
Colorectal Surgery 144.76 £9,699,740 67,589 1
Rheumatology 157.03 £8,903,213 38,765 1
Clinical Oncology (previously Radiotherapy) 109.09 £8,545,642 34,121 1
Clinical Haematology 91.88 £8,138,534 27,486 1
Oral Surgery 190.67 £7,923,849 65,277 1
Geriatric Medicine 78.52 £7,560,302 30,896 1
Plastic Surgery 131.02 £5,959,405 51,150 1
Vascular Surgery 96.63 £5,529,751 31,443 1
Maxillo Facial Surgery 94.97 £5,188,905 46,532 1
Transient Ischaemic Attack 31.66 £5,141,943 16,135 1
Pain Management 101.82 £5,082,915 30,700 1
Medical Oncology 55.77 £4,767,785 22,488 1
Diabetic Medicine 58.99 £4,494,740 22,350 1
Paediatric Trauma and Orthopaedics 58.10 £4,215,123 27,481 1
Clinical Neurophysiology 40.93 £4,189,508 21,753 1
Respiratory Physiology 37.14 £3,946,838 19,063 1
Nephrology 43.93 £3,893,766 14,258 1
Endocrinology 63.36 £3,828,580 20,099 1
Paediatric Ophthalmology 50.81 £3,487,595 25,299 1
Gynaecological Oncology 37.91 £3,237,008 18,761 1
Spinal Surgery Service 36.20 £3,005,748 18,052 1
Clinical Physiology 29.95 £2,758,659 16,269 1
Anaesthetics 50.96 £2,576,494 26,267 1
Infectious Diseases 14.33 £2,324,295 7,421 1
Audiology 36.20 £2,279,547 19,663 1
Hepatology 21.75 £2,068,117 10,673 1
Paediatric Cardiology 19.94 £2,023,555 8,209 1
Upper Gastrointestinal Surgery 31.86 £2,007,709 16,281 1
Orthodontics 32.51 £1,835,870 12,033 1
Paediatric Ear Nose and Throat 32.63 £1,816,807 16,395 1
Paediatric Surgery 28.27 £1,803,247 10,638 1
Cardiothoracic Surgery 10.04 £1,415,355 5,453 1
Paediatric Respiratory Medicine 11.17 £1,354,884 5,162 1
Cardiac Surgery 9.80 £1,239,187 4,673 1
Paediatric Dermatology 19.34 £1,203,547 9,137 1
Paediatric Endocrinology 6.59 £1,055,450 2,737 1
Thoracic Surgery 7.11 £1,030,348 3,863 1
Paediatric Gastroenterology 9.39 £986,701 3,828 1
Hepatobiliary & Pancreatic Surgery 8.86 £939,342 4,813 1
Neurology 9.28 £937,691 5,041 1
Paediatric Dentistry 10.69 £903,461 5,808 1
Audiological Medicine 14.21 £900,114 7,717 1
Restorative Dentistry 14.19 £874,652 7,212 1
Interventional Radiology 5.23 £805,727 2,840 1
Paediatric Urology 10.37 £796,308 4,518 1
Paediatric Plastic Surgery 11.66 £774,416 5,678 1
Paediatric Clinical Haematology 2.84 £660,152 1,543 1
Obstetrics 5.01 £451,650 2,723 1
Dental Medicine Specialties 5.61 £362,281 3,045 1
Allergy 3.96 £313,770 2,151 1
Paediatric Epilepsy 1.70 £197,303 923 1
Midwife episode 2.49 £196,144 1,354 1
Medical Ophthalmology 2.88 £187,337 1,563 1
Paediatric Maxillo-facial Surgery 2.30 £176,902 1,249 1
Paediatric Clinical Immunology and Allergy 1.92 £158,507 1,044 1
Physiotherapy 1.34 £123,460 728 1
Paediatric Diabetic Medicine 1.11 £123,314 605 1
Orthoptics 1.82 £108,659 990 1
Paediatric Audiological Medicine 1.23 £72,814 668 1
Optometry 1.10 £68,812 600 1
Genitourinary Medicine 0.94 £67,652 513 1
Podiatry 0.85 £60,807 464 1
Clinical Immunology & Allergy 0.81 £59,582 442 1
Occupational Therapy 0.67 £48,184 362 1
Accident & Emergency (A&E) 0.62 £42,848 336 1
Neonatology 0.34 £33,206 187 1
Congenital Heart Disease Service 0.32 £28,527 175 1
Stroke Medicine 0.30 £26,926 164 1
Burns Care 0.35 £23,679 192 1
Clinical Pharmacology 0.26 £22,822 140 1
Community Paediatrics 0.33 £20,087 180 1
Rehabilitation 0.22 £19,801 119 1
Programmed Pulmonary Rehabilitation 0.17 £15,180 92 1
Neurosurgery 0.16 £14,246 88 1
Paediatric Burns Care 0.15 £10,016 84 1
Anticoagulant Service 0.09 £8,725 48 1
Speech and Language Therapy 0.11 £7,493 61 1
Clinical Immunology 0.09 £6,711 48 1
Dietetics 0.06 £5,849 32 1
Paediatric Medical Oncology 0.04 £4,825 21 1
Transplantation Surgery 0.05 £4,107 27 1
Tropical Medicine 0.05 £3,962 26 1
Paediatric Neurology 0.04 £3,618 22 1
Cardiac Rehabilitation 0.03 £3,064 16 1
Chemical Pathology 0.03 £2,771 17 1
Paediatric Cardiac Surgery 0.03 £2,396 14 1
Nuclear Medicine 0.09 £1,962 51 1
Critical Care Medicine 0.01 £1,844 4 1
Bone & Marrow Transplantation 0.01 £1,780 8 1
Clinical Psychology 0.02 £1,695 9 1
Cardiothoracic Transplantation 0.02 £1,517 9 1
Paediatric Neuro-disability 0.01 £1,141 7 1
Orthotics 0.01 £753 4 1
Paediatric Nephrology 0.00 £528 2 1
Clinical Genetics 0.01 £414 3 1
Palliative Medicine 0.00 £385 2 1
Paediatric Rheumatology 0.00 £326 2 1
Paediatric Neurosurgery 0.00 £167 1 1
Clinical Microbiology 0.00 £163 1 1
Paediatric Infectious Diseases 0.00 £140 1 1

Some outpatient appointments could be eliminated by handling them in other ways. Many patients could be treated effectively and more cheaply outside hospital altogether, and follow-up of some could be conducted over the telephone.

The Department of Health has identified the opportunities for outpatient work to be moved out of the hospital into the community. It has identified six specialties in which most outpatient care could be provided outside of hospital. These are: dermatology, ENT, general surgery, orthopaedics, urology and gynaecology. The DH is currently working with the Royal Colleges to define clinically safe pathways for these specialties to ensure that the right care is provided in the right environment.

Key steps :

  • CCGs should analyse their outpatient referral rates to ensure that they are in line with expected levels.
  • CCGs should introduce systems to monitor GP referral rates and provide feedback to them. Practice-based commissioning can be used to incentivise GPs to reduce referral levels where they are overly high.
  • Increase the number of GPs with a special interest, so that patients can be referred to them rather than hospital outpatients. In many countries, virtually no outpatient appointments are carried out in hospitals. Providing care outside of the hospital is more cost effective and often more convenient for patients.
  • Develop the skills of nurses and allied health professionals, so that they can take on work from GPs, such as providing first contact care and tailored services for patients with long-term illnesses, such as diabetes and chronic lung disease.
Useful Links

For detail about the standardisation methods used please visit http://www.nhselect.nhs.uk/Service-Transformation/Better-Care-Better-Value-Indicators

INFORMATION SHOWN

This indicator shows the directly standardised rate of first attendance per 100,000 population. A higher rate may suggest poor management of thresholds for referral.

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