Transforming Outpatients Services
Outpatient services are a key part of how the NHS supports people living with long-term conditions, recovering from procedures, or accessing specialist care. However, for many patients, these services have not always felt flexible, personal, or easy to navigate. Recognising this, LGT is reshaping how outpatient care is delivered, placing greater emphasis on accessibility, personalisation, and patient choice.
Listening to Patients: Co-Designing a Better Service
To ensure changes genuinely reflect the needs and experiences of patients locally, LGT partnered with Healthwatch Greenwich and other local Healthwatch in south east London to carry out a focused engagement programme. Over six weeks, we spoke to hundreds of residents about their experiences of using the Trust's outpatient services, focusing on how patients accessed information, managed appointments, and felt about their overall care. These conversations were not just about identifying problems, they were about understanding what works well, what patients value, and how services can be made more inclusive. Our findings formed the basis of a patient-informed action plan used to support the Trust in redesigning outpatient services with our community in mind. As Nora Gill, Transformation Programme Manager at LGT, explains:
"Our best improvements will always emerge when they are informed by our patients’ feedback, since they are the ones who truly experience our service.”
Equipping Patients with the Right Information
One of the strongest messages we heard from patients was that they often felt unprepared before attending their appointments. Many said they didn’t know what to expect, how long they might have to wait, or what would happen during the consultation. This lack of clarity created anxiety and, in some cases, led to missed or ineffective appointments. In response to our recommendations, the Trust has taken meaningful steps to improve patient information. They report collaborating closely with patient representatives to co-design a new ‘Information for your visit’ section, now included in every appointment letter. This section offers practical guidance on essential topics such as parking, travel costs, clinic waiting times, and what to bring on the day.
Additionally, they share that when specific preparation is required for an individual appointment, they have clearly outlined these instructions in the letter, tailored to that specific visit. These enhancements aim to reduce patient anxiety and help ensure appointments are more effective and productive.
Making Contact with the Trust Easier
Beyond improving information, our engagement revealed a common frustration among patients: difficulty contacting the hospital, especially when trying to rearrange appointments. In some cases, people told us they had waited on hold for over an hour, only to be transferred multiple times or not get through at all. In response, the Trust says it has made considerable progress in improving how patients can contact the service.
They state that all appointment letters now include a dedicated email address, giving patients an alternative contact method that may better suit their preferences. They have also revised staffing levels in the Outpatient call centre, cutting average phone wait times dramatically from around an hour to just 2–8 minutes.
In addition, the Trust says it has updated its main switchboard with refreshed contact details to ensure calls are directed more efficiently. “Patients told us that getting through to the hospital was one of their biggest challenges. These changes mean that patients should no longer have to wait endlessly, and getting passed around to multiple departments is minimised,” notes Nora.
To further support communication, the Trust says it has introduced a new patient portal system. Accessible via the NHS App or secure links in Trust SMS messages, the portal allows patients to view appointment letters online. Patients are said to also receive text notifications when new letters are available, alongside the standard appointment reminders. For many, this digital option intends to offer greater convenience, faster access, and avoid the risk of postal delays or lost letters.
Inclusive Services: Meeting the Needs of Every Patient
While these communication improvements stand to benefit everyone, our findings revealed that some groups faced particular barriers when accessing outpatient care. Patients with sensory impairments and learning disabilities told us that they often struggled to get the information they needed in a way that worked for them. To address this, the Trust says it has worked alongside a disability focused patient group to complete a full equality impact assessment, comprehensively reviewing outpatient departments to understand where the facilities and communication fell short for patients requiring additional support.
“This was about listening and acting on lived experience. The patients we worked with showed us exactly where improvements were needed, and we responded.”
Based on the Healthwatch report and collaborating with the patient experience group, the Trust says it has introduced a number of accessibility-focused changes.
They share that all clinic receptions are now equipped with hearing loops, and appointment letters have been redesigned to meet the Accessible Information Standard, including a larger default font size of 14. The Trust says they have also activated a digital ‘Reasonable Adjustment’ flag in their patient records system. This allows staff to record and retain information about a patient's specific accessibility needs, so they don't have to repeat them at every visit unless their needs change.
Moreover, they share that work is also underway to provide appointment letters in a range of accessible formats, including Easy Read, large print, and Braille. Patients can request their preferred format, and this preference will be recorded via the digital flag to ensure future communications meet their needs.
Additionally, the Trust states that physical accessibility is being addressed. Queen Elizabeth Hospital’s Outpatient department now features clearer, larger-font signage, improved placement for wheelchair users, and added symbol signs. Similar upgrades are planned for University Hospital Lewisham.
Supporting Patients to Have Greater Say in Their Care
As part of the wider transformation of outpatient care, the Trust announced its introduction of a partial booking system, a change directly informed by Healthwatch Greenwich’s recommendation to consider patient availability. Instead of receiving a fixed appointment time, patients are invited to select a slot that suits them within a six-week window. According to the Trust, this approach is already in use for therapy services. The aim is to reduce last-minute cancellations and make it easier for patients to plan around work, family, and other responsibilities.
To promote more active involvement in care, the Trust states that appointment letters now include prompts for shared decision-making. Patients are encouraged to think about their concerns in advance and come prepared with questions. “Thinking about their concerns and questions ahead of time and maybe writing them down is really important,” explains Nora. “As arriving at the hospital can be overwhelming, and it’s easy to forget what you wanted to ask.”
Another step the Trust says it has taken is the introduction of Patient-Initiated Follow-Up (PIFU). This model recognises that recovery doesn’t follow a one-size-fits-all timeline. Rather than attending a routine follow-up that may no longer be necessary, eligible patients can now contact the Trust to book a follow-up only if they need one. This more personalised approach intends to give patients greater control and avoid unnecessary appointments.
Finally, for suitable cases, the Trust says it offers remote consultations via phone or video. These appointments provide a practical alternative for patients who don’t need to be seen in person, saving travel to the hospital.
A Stronger System Through Partnership
Throughout this transformation, the role of patient voices has been essential in shaping a service that truly reflects the needs of those who use it. By working closely with LGT, Healthwatch Greenwich, alongside our fellow Healthwatch partners, has played a vital part in refining outpatient services to make them more personalised, accessible, and equitable. Our work is actively shaping how care is delivered, ensuring that barriers to access are identified and addressed. Through honest feedback, clear recommendations, and ongoing collaboration, we’re helping to create a system where patients are well-informed, better prepared for treatment, and fully supported in achieving the best possible health outcomes. “Healthwatch Greenwich has been instrumental. 50% of the feedback we received came through your outreach,” shares Nora. “Your reports are always thorough, balanced, and honest, which is exactly what we need to drive change.”
Together, we are helping to reduce health inequalities by improving access to information, strengthening communication, and ensuring that care is responsive to patient needs. At their core, these changes are helping to embed listening and partnership at the heart of outpatient care.
Nora Gill is the Transformation Programme Manager for Outpatient Services at Lewisham and Greenwich NHS Trust. With a deep passion for enhancing patient care, Nora works closely with teams across outpatient services to lead meaningful improvements, streamline processes, and enhance patients’ overall experiences of care.
