Outpatient Services Performance Improvement Programme

Delivering outpatient care is a core activity of the acute hospital system. They include Emergency Department services as well as planned services provided on an out-patient basis. For example, you may be referred by your family doctor (GP) for specialist assessment by a consultant or his or her team or for diagnostic assessments such as x-rays or laboratory tests or for treatment such as physiotherapy. Patients can access diagnostics, face to face consultation, certain procedures or consultation or treatments with medical staff.

The Outpatient Services Performance Improvement Programme (OSPIP) 2016-2020 aims to address key issues affecting outpatient services (OP), including wait times for access to services, standardisation in delivery of service, service capacity and/or waste of capacity and ad-hoc development of services. The programme is also looking at how outpatient services could be delivered outside of hospitals in community services such as Primary Care Centres, GP practices and Ambulatory Care Centres.

The Strategy for the Redesign of Outpatient Services 2016-2020 sets out the vision for the redesign of outpatient services and builds upon the work of the performance improvement programme carried out between 2011 and 2015. The Programme have been working with a wide range of stakeholders including patients to reorganise services to deliver the very best in modern healthcare, in the best location, when it is needed, while at the same time, delivering value for money to the population that funds this healthcare.


Key deliverables for this strategy that are currently in development:

  • Outpatient referral pathways per specialty
  • Enhanced electronic referral management system
  • Embedded health education and promotion ethos
  • Integrated outpatient services
  • Telemedicine and virtual clinics
  • Electronic decision support tool for GPs and other sources of referral
  • Improved outpatient environments


What This Means For Patients



Our current outpatient service offers, in the main, only one option to the GP when the patient requires diagnostics and/or care not available in that practice. This single option is a referral to acute services. The GP has limited access to diagnostics and specialist advice and little or no access to support regarding management of chronic disease. Urgent, semi-urgent and non-urgent patients wait for service in a single queue, with the result being that non-urgent patients are de-prioritised behind those with acute need, resulting in longer wait times for these patients.



Standardised referral pathways, operationalised through a GP decision support tool and centralised referral services, will place patients on the appropriate route from the commencement of the care process. Those with urgent and semi-urgent healthcare need will be fast-tracked to acute specialist services. Those with non-urgent healthcare need will be seen in a timely manner in the acute hospital by specialist teams or in integrated care services delivered in the community. GPs will have enhanced access to diagnostics, one-stop shops and advice though their ICT systems or via telemedicine. Telemedicine will be available within integrated care services and eventually, in the patient’s home.

Read more on the Outpatient Services Performance Improvement Programme Strategy

The Outpatient Waiting List Action Plan 2017 focused on reducing the number of patients waiting 15 months or more for outpatient appointments by 50% by the end of October 2017. 

The National Treatment Purchase Fund compiles data each month on the number of patients and the length of time they are waiting for an outpatient appointment. This also includes a breakdown of information by area of speciality.