Abstract：
BACKGROUND: The National Health Service (NHS) Long Term Plan was published in January 2019. One of its objectives was restructuring outpatient services, as part of an Outpatient Transformation initiative. Monitoring of trusts\' adherence to the objectives of the Long Term Plan is therefore required to benchmark progress against national objectives.
OBJECTIVE: We aimed to explore whether outpatient transformation initiatives and phlebotomy services that are managed by outpatients are appropriately staffed and to evaluate trusts\' adherence to the objectives outlined in the Long Term Plan.
METHODS: A freedom of information (FOI) request was sent in January 2023 to 153 trusts across Great Britain (time span: 1 January 2022-31 December 2022). Parameters requested included number of outpatients seen/discharged, phlebotomy episodes, number of sites/wards covered by phlebotomy, target/actual did not attend (DNA) rates, time since inception of the outpatient transformation project (OTP), advice and refer (A&R) and patient-initiated follow-up (PIFU), phlebotomy and outpatient managerial establishment and use of electronic notes and patient portals.
RESULTS: A total of 117 trusts (76.5%) provided responses to the FOI request. The mean number of new outpatients seen face-to-face was 185,810. Of 73 trusts reporting both actual and target DNA rates, 62 (84.9%) did not meet their DNA targets. The actual DNA rate was significantly greater than the target DNA rate across trusts (p < 0.001, mean: 8.8% vs. 6.5%, respectively). A total of 58 different electronic systems and 29 patient portals were utilised across trusts. Thirty-six trusts (30.3%) did not have an outpatient transformation project manager and 16 trusts (13.7%) did not initiate an OTP. With phlebotomy provision, the mean number of outpatient phlebotomy episodes was lower than inpatient episodes (83,383 vs. 91,020, respectively).
CONCLUSIONS: There are deficiencies in current outpatient establishments that may hinder the achievement of objectives set in the NHS Long Term Plan. Changes at all levels of healthcare are required, with increased reliance on technologies and investment in support for transformation management.
OBJECTIVE: We aimed to explore whether outpatient transformation initiatives and phlebotomy services that are managed by outpatients are appropriately staffed and to evaluate trusts\' adherence to the objectives outlined in the Long Term Plan.
METHODS: A freedom of information (FOI) request was sent in January 2023 to 153 trusts across Great Britain (time span: 1 January 2022-31 December 2022). Parameters requested included number of outpatients seen/discharged, phlebotomy episodes, number of sites/wards covered by phlebotomy, target/actual did not attend (DNA) rates, time since inception of the outpatient transformation project (OTP), advice and refer (A&R) and patient-initiated follow-up (PIFU), phlebotomy and outpatient managerial establishment and use of electronic notes and patient portals.
RESULTS: A total of 117 trusts (76.5%) provided responses to the FOI request. The mean number of new outpatients seen face-to-face was 185,810. Of 73 trusts reporting both actual and target DNA rates, 62 (84.9%) did not meet their DNA targets. The actual DNA rate was significantly greater than the target DNA rate across trusts (p < 0.001, mean: 8.8% vs. 6.5%, respectively). A total of 58 different electronic systems and 29 patient portals were utilised across trusts. Thirty-six trusts (30.3%) did not have an outpatient transformation project manager and 16 trusts (13.7%) did not initiate an OTP. With phlebotomy provision, the mean number of outpatient phlebotomy episodes was lower than inpatient episodes (83,383 vs. 91,020, respectively).
CONCLUSIONS: There are deficiencies in current outpatient establishments that may hinder the achievement of objectives set in the NHS Long Term Plan. Changes at all levels of healthcare are required, with increased reliance on technologies and investment in support for transformation management.
摘要：
背景：国家卫生服务（NHS）长期计划于2019年1月发布。其目标之一是调整门诊服务结构,作为门诊转型计划的一部分。因此，需要监测信托对长期计划目标的遵守情况，以对照国家目标衡量进展。
目的：我们旨在探讨门诊患者管理的门诊转型计划和放血服务是否配备了适当的人员，并评估信任对长期计划中概述的目标的遵守情况。
方法：信息自由（FOI）请求于2023年1月发送给英国的153个信托基金（时间跨度：2022年1月1日至2022年12月31日）。要求的参数包括门诊就诊/出院的人数，静脉放血发作，静脉放血覆盖的地点/病房数量，目标/实际未参加（DNA）率，自门诊改造项目(OTP)启动以来的时间，建议和转诊(A&R)和患者发起的随访(PIFU)，静脉放血和门诊管理的建立和使用电子笔记和患者门户。
结果：共有117个信托（76.5％）对FOI请求提供了响应。面对面的新门诊患者的平均人数为185,810。在报告实际和目标DNA比率的73个信托中，62(84.9%)没有达到他们的DNA目标。不同信托的实际DNA率显著高于目标DNA率(p<0.001，平均值：8.8%与6.5%,分别)。共有58个不同的电子系统和29个患者门户网站被用于信托。36个信托（30.3%）没有门诊转型项目经理，16个信托（13.7%）没有发起OTP。有了放血的规定，门诊放血发作的平均次数低于住院发作(83,383例vs.分别为91020）。
结论：当前的门诊机构存在缺陷，可能会阻碍实现NHS长期计划中设定的目标。各级医疗保健都需要改变，随着对技术的依赖和对支持转型管理的投资的增加。
目的：我们旨在探讨门诊患者管理的门诊转型计划和放血服务是否配备了适当的人员，并评估信任对长期计划中概述的目标的遵守情况。
方法：信息自由（FOI）请求于2023年1月发送给英国的153个信托基金（时间跨度：2022年1月1日至2022年12月31日）。要求的参数包括门诊就诊/出院的人数，静脉放血发作，静脉放血覆盖的地点/病房数量，目标/实际未参加（DNA）率，自门诊改造项目(OTP)启动以来的时间，建议和转诊(A&R)和患者发起的随访(PIFU)，静脉放血和门诊管理的建立和使用电子笔记和患者门户。
结果：共有117个信托（76.5％）对FOI请求提供了响应。面对面的新门诊患者的平均人数为185,810。在报告实际和目标DNA比率的73个信托中，62(84.9%)没有达到他们的DNA目标。不同信托的实际DNA率显著高于目标DNA率(p<0.001，平均值：8.8%与6.5%,分别)。共有58个不同的电子系统和29个患者门户网站被用于信托。36个信托（30.3%）没有门诊转型项目经理，16个信托（13.7%）没有发起OTP。有了放血的规定，门诊放血发作的平均次数低于住院发作(83,383例vs.分别为91020）。
结论：当前的门诊机构存在缺陷，可能会阻碍实现NHS长期计划中设定的目标。各级医疗保健都需要改变，随着对技术的依赖和对支持转型管理的投资的增加。
