Outpatient clinic (hospital department)

An outpatient department or outpatient clinic is the part of a hospital designed for the treatment of outpatients, people with health problems who visit the hospital for diagnosis or treatment, but do not at this time require a bed or to be admitted for overnight care. Modern outpatient departments offer a wide range of treatment services, diagnostic tests and minor surgical procedures.

This article is about outpatient clinic or departments of hospitals. For outpatient clinics not connected with hospitals, see clinic.

Department

The outpatient clinic of a hospital, also called an outpatient department provides diagnosis and care for patients that do not need to stay overnight.[1] This is distinct from clinics independent of hospitals, almost all of which are designed mostly or exclusively for outpatient care and may also be called outpatient clinics.

The outpatient department is an important part of the overall running of the hospital. It is normally integrated with the in-patient services and manned by consultant physicians and surgeons who also attend inpatients in the wards. Many patients are examined and given treatment as outpatients before being admitted to the hospital at a later date as inpatients. When discharged, they may attend the outpatient clinic for follow-up treatment.[2]

The outpatient department will usually be on the ground floor of the hospital with car-parking facilities nearby. Wheelchairs and stretchers are available for non-ambulatory patients. Patients will register at a reception desk and there is seating for them while they wait for their appointments. Each doctor will have a consulting room and there may be smaller waiting areas near these. Paediatric clinics are often held in areas separated from the adult clinics. Close at hand will be X-ray facilities, laboratories, the medical record office and a pharmacy. In the main waiting area there are a range of facilities for the patients and their families including toilets, public telephones, coffee shop or snack bar, water dispenser, gift shop, florist and quiet room.[2]

Not all hospitals have separate outpatient departments, so outpatients may be treated in the same departments as patients that stay overnight.

Reform

The Royal College of Physicians said that UK outpatient clinics were stuck "in the 18th Century" and an expensive waste of time and money. There were 127 million appointments in 2017 and about 20% of them were cancelled or the patient did not turn up. 57% of them ran late. They wanted more use of remote monitoring, telephone and video consultations and senior nurses running clinics closer to people's homes.[3] The NHS Long Term Plan proposed that up to a third of face-to-face outpatient appointments should be done by video link by 2024.[4] The COVID-19 pandemic in England spurred radical shifts to video appointments as most routine appointments were cancelled. The Attend Anywhere digital healthcare service was installed across NHS organisations in England in March 2020 with backing from NHSX and by May 2020 had been used for more than 79,000 consultations. [5]

Payment

NHS England proposed changes to payment systems in 2018 aimed at reducing the number of consultant-led appointments and incentivising hospitals to conduct more appointments remotely.[6]

References
  1. Segen's Medical Dictionary and Medical Dictionary for the Health Professions and Nursing
  2. Kunders, G.D. (2004). Hospitals: Facilities Planning and Management. Tata McGraw-Hill Education. pp. 221–222. ISBN 978-0-07-050269-7.
  3. "NHS outpatients service 'stuck in the 18th Century'". BBC. 9 November 2018. Retrieved 9 November 2018.
  4. "The doctor will call you now: Outpatient video consultations for the NHS". Building Better Healthcare. 23 June 2020. Retrieved 2 August 2020.
  5. "Covid sparks boom in digital hospital outpatient appointments". Health Service Journal. 11 May 2020. Retrieved 28 June 2020.
  6. "Tariff set to cut payments for traditional outpatient appointments". Health Service Journal. 25 June 2018. Retrieved 5 September 2018.
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