Rethinking Outpatients
How HBSUK Is Delivering the Future of Planned Specialist Care
In April 2025, the Royal College of Physicians, in partnership with the Patients Association, published a bold and timely report: Prescription for Outpatients. The report acknowledges the dedication of NHS professionals but also highlights a system under immense strain. Just days later, the BMJ echoed these concerns, noting that the outpatient model, while essential, is showing signs of serious pressure.
With over 135 million outpatient appointments annually, and 7.4 million people waiting for treatment, teams across the NHS are working tirelessly to manage demand and improve access. Much progress has already been made, particularly in the wake of the pandemic, which accelerated digital adoption and innovative practices. But many frontline clinicians and managers still face daily challenges—long delays, duplicated processes, and growing pressures on capacity.
At HBSUK, we believe this moment presents a once-in-a-generation opportunity to radically reshape planned care. Through our digital outpatient platform, we are helping NHS Trusts move beyond legacy models toward a future that is more patient-focused, digitally enabled, and clinically effective. Our strategic approach focuses on precision navigation, ensuring accurate delivery to the right service, first time, underpinned by a connected digital platform that links patients and clinicians, services, information, in-person care, and personal health data.
The Problem with the Traditional Outpatient Model
Outpatient care was historically designed for a time when access to specialists could only occur through in-person consultations. But as health needs have evolved and technology has advanced, the system has remained rigid. Patients are routinely forced into unnecessary appointments. Clinics are booked months in advance. And clinicians, despite their expertise, often operate with incomplete data or under inflexible job plans.
The BMJ reports systemic issues such as delayed letters, last-minute cancellations, and difficulty navigating services. Many patients miss critical treatment windows, while others attend appointments that provide little value. Fragmented IT systems make it difficult for clinicians to share vital information, while patient frustration erodes trust.
A Royal College of Physicians snapshot survey found that 69% of physicians lack the tools and time to prioritise patients based on clinical risk. This is not just inefficient; it is unsafe. And it demands more than incremental fixes.
A Vision for the Future
The Prescription for Outpatients report lays out a compelling roadmap for reform. At its heart are five key ambitions:
- Achieve the best patient outcomes by providing timely care for patients, delivered by the right person in the right setting.
- Empower and support patients to take a full and active role in their health by delivering personalised care methods, including shared decision making, support planning and supported self-management.
- Provide seamless care by improving mechanisms for communication with patients and the professionals involved in their care.
- Deliver efficient and effective care in novel and innovative ways that value patients’ time and avoid unnecessary appointments.
- Use data and technology to identify patients most at risk and prioritise care according to need, thereby reducing health inequalities and preventing ill health and complications.
The report envisions the shift in how outpatient care is delivered: from a one-size-fits-all approach to personalised pathways; from siloed teams to integrated systems; from reactive treatment to proactive health management.
A notable shift is also linguistic: replacing the term “outpatients” with “planned specialist care” to reflect a broader, more holistic approach that includes education, diagnostics, monitoring, and prevention.
Where HBSUK Comes In
HBSUK’s digital outpatient platform directly delivers many of the ambitions set out in the RCP’s vision. Developed with clinicians, for clinicians, it is designed to streamline assessment, prioritise clinical time, and empower patients.
Our platform stands apart in that all pathways are designed by NHS consultants that have held substantive NHS posts within the last two years, and the majority of cases are reviewed by the consultants themselves. This ensures clinical accuracy, quality assurance, and alignment with real-world patient needs.
Patients can complete structured questionnaires and upload relevant images or health information at their convenience. Clinicians then review and respond within 72 hours, without the need for a traditional appointment.
The platform allows consultants to determine next steps, request investigations, or plan interventions before an appointment is booked. This pre-appointment review ensures time is spent where it adds the most value. It supports precision navigation into the right service from the outset, reducing delays and improving clinical outcomes.
Every patient receives a bespoke care outcome, ranging from reassurance and discharge to a detailed treatment plan. In many cases, patients do not require a face-to-face review, allowing consultants to focus their time on those with more complex needs. Our digital healthcare pathways are comprehensive, enabling care to be delivered digitally when possible and in-person when necessary.
Access is not limited by geography. The platform has proven effective in both rural areas of the UK and overseas territories like St Helena. It is adaptable to different clinical and patient contexts.
Importantly, the platform integrates with NHS systems, is governed by a CQC-registered clinical framework, and enables Trusts to scale quickly without placing additional strain on existing infrastructure.
Our model also differs in scale and flexibility. Unlike more limited offerings, our platform supports multiple, diverse clinical pathways, offering breadth and agility to elective care solutions.
From Theory to Practice
North Cumbria Integrated Care (NCIC) faced a 60+ week wait for neurology appointments. HBSUK deployed a hybrid model using the digital outpatient platform for remote assessments, complemented by face-to-face insourcing for patients who required or preferred it. As a result, 22% of patients were discharged directly and 7% no longer required appointments. All 1,200 longest-waiting patients were reviewed in a matter of weeks. The project also featured successful integration with the Trust’s electronic patient record system, demonstrating how digital care models can work safely and effectively within NHS infrastructure. It also highlighted the importance of flexibility on both sides: pathways that adapt to patients, and NHS systems open to innovation from trusted providers.
At Buckinghamshire Healthcare NHS Trust, the platform was piloted in dermatology. Within 12 weeks, the Trust achieved a 37% reduction in the dermatology patient tracking list. In addition, 62% of patients had their RTT clock stopped. The project delivered significant environmental savings, improved patient satisfaction, and recorded zero re-referrals.
The St Helena Government also partnered with HBSUK to assess orthopaedic patients remotely. Despite limited connectivity and digital literacy, patients were supported through the platform, resulting in safe, timely outcomes and the ability to manage complex care needs in one of the most remote settings under UK jurisdiction.
These examples are not pilots. They are proof points that show what can happen when digital technology, clinical insight, and operational expertise are aligned.
Challenges and Considerations in Reforming Outpatients
Real change demands more than technology. Some consultants still see digital models as tools for reviewing rather than delivering full care pathways. Others are constrained by job plans that do not account for asynchronous or flexible working. Additionally, digital exclusion remains a real concern for parts of the population.
That is why HBSUK does more than deploy software. We work with Trusts to train clinicians on digital-first approaches, ensure alignment with job planning and productivity metrics, support inclusive patient engagement, and uphold high standards of governance and peer review.
Our model is clinically led, operationally robust, and regulated by the CQC. It has been purpose-built for the needs and structures of the NHS.
Delivering the 10-Year Plan Starts Here
The challenges facing the NHS outpatient model are systemic. But so too are the opportunities.
Our digital outpatient platform delivers what the RCP and BMJ are calling for: smarter, faster, safer care that reduces unnecessary activity and focuses on outcomes. It is not just a digital product; it is a pathway transformation service. Our approach combines precision navigation, comprehensive digital healthcare pathways, and a connected platform that supports the full journey between patients, clinicians, services, and data.
If we want to create a health system that is fit for the next decade, we need to stop trying to fix the past and start building the future. At HBSUK, we are proud to be doing exactly that, alongside NHS partners, patients, and clinicians.
Let us make planned specialist care work for everyone.
