1. Outpatient Services

2. What are they?
“An outpatient is someone who goes to a hospital or clinic for a procedure which does not require a stay overnight”
“An outpatient is a patient who is not hospitalised for 24 hours or more but who visits a hospital, clinic, or associated facility for diagnosis or treatment.”
“It is usually the step in the patient’s pathway where diagnostic tests are reviewed and the decision to treat (or request additional testing) is made.”

3. Outpatient services in North Wales
700 thousand attendances to clinics across 28 sites (2010/11)
8.5% in a community setting
Strategic review of outpatient services for Medical and Surgical specialties (388,000)

4. Review of outpatient services
To explore innovative and better service options
“There was no one common model of outpatient service delivery that emerged from the literature as an optimum model of care in terms of improved patient outcomes and cost effectiveness”
To ascertain whether outpatient services are being run as cost effectively and as efficiently as possible

5. Acute Hospital Sites Community Locations West Central East
Ysbyty Gwynedd Llandudno General Hospital
Bryn Beryl Hospital Bryn-y-Neuadd Hospital
Cefni Hospital
Dolgellau & Barmouth District Hospital
Eryri Hospital
Blaenau Ffestiniog Health Centre
Ysbyty Alltwen
Ysbyty Penrhos Stanley
Central
Glan Clwyd Hospital Abergele Hospital
Colwyn Bay Community Hospital
Denbigh Community Hospital
Holywell Community Hospital
Royal Alexandra Hospital
Ruthin Community Hospital
East
Wrexham Maelor
Chirk Community Hospital
Deeside Community Hospital
Llangollen Community Hospital
Mold Community Hospital
Grove Road Health Centre
Plas Y Bryn Health Centre

6. What could we do?
We can move some clinics from acute settings to community settings but there are other opportunities to improve the patient experience…..
Primary care clinics for chronic diseases
Direct access by GPs to specialist diagnostic tests, investigations and treatments
Rapid access to consultant advice e.g.
GP with special interest
Specialist Nurse Clinics
Telemedicine
Follow up by GPs
Follow up by telephone
One Stop Clinics
Rapid Access Clinics
Direct Access Clinics
Patient initiated follow up

7. Challenges Access Critical mass for services
Staffing capacity and skills
Capital and estate issues
Coordinated access to diagnostics
Finance and resource availability