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Clinicians’ concerns have held-up outpatient reform, says Mackey

NHS England’s outpatients’ recovery efforts have been stymied by a lack of funding and because “we’ve struggled to get the clinical community uniformly behind it”, Sir Jim Mackey has told MPs.

The NHSE chief executive told a Public Accounts Committee evidence session that national leaders all accepted “we have to do more on outpatients” and revealed that a new outpatient recovery plan was being finalised for next year.

Asked if outpatients should have been more of a focus of NHS resources, Sir Jim said: “Yeah. I think the programme probably was under-resourced at the time.”

He added: “But I think the material issue throughout has been clinical engagement, and we’ve struggled throughout to get the clinical community uniformly behind it. So, once we’ve achieved that, the thing will get resolved.”

He continued: “The big concern that’s prevented us from going really hard at it is the concern about missing clinical risk. So, if we do really sweeping changes without really strong clinical engagement, that [could mean] a patient should have been seen in a follow-up setting and wasn’t and comes to harm. None of us wants that.

“We all agree outpatients is the big untapped thing for us to go at that can be dealt with without a lot of resource, but it’s very complicated.”

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Source: HSJ, 11 September 2025

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