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Supporting the outpatient transformation programme in North East and Yorkshire

Our Improvement Unit supported the implementation of the outpatient transformation programme, optimising virtual consultations, increasing the rollout of patient initiated follow up and mapping data from lessons learnt during COVID-19 to restore elective care.


In aid of the COVID-19 recovery strategy, a regional outpatients transformation programme was developed with the four integrated care systems (ICSs) across the North East and Yorkshire region. The aim was an accelerated return to near-normal levels of non-COVID health services, making full use of elective care capacity and adapting beneficial practices brought on by COVID-19.

The Midlands and Lancashire Commissioning Support Unit (MLCSU) was asked to help implement the programme through practical project management support to both ICSs and NHS trusts. Our contribution focused on specific regional and ICS programme priorities: increasing virtual consultation, patient initiated follow up and improved advice and guidance.


An MLCSU Improvement Consultant was deployed and quickly embedded into the South Yorkshire and Bassetlaw (SYB) ICS which led on the Advice and Guidance element of the programme.

We also:

  • Optimised virtual consultations, building on existing work undertaken as part of COVID-19, ensuring that this work is sustained and continues to support elective recovery across the region
  • Increased the rollout of patient initiated follow up through an accelerated programme of fast-track pathway improvements for patients
  • Helped establish a working group to test and implement advice and guidance, developing a common approach to evidencing the impact and recommending the best solution to increase usage across all outpatients services
  • Facilitated workshops on the functionality of the e-Referrals Service system at each ICS
  • Collaborated with CCGs, primary and secondary care providers, the National Elective Care Recovery and Transformation Programme, the Referral Optimisation Team, NHS Digital and NHS England and Improvement (NHSEI) equalities leads.


Video consultations work addressed inequalities and digital poverty, removing barriers to effective elective recovery and longer-term transformation.

Patient initiated follow up reduced unnecessary outpatient appointments, supporting recovery.

South Yorkshire and Bassetlaw was one of three ICSs in the country to assist the National Advice and Guidance team.

We also:

  • Collated and presented e-Referrals Service system developments to NHS Digital and NHSEI
  • Developed a matrix to map advice and guidance case studies and research across each ICS
  • Analysed data from lessons learnt to inform specialty focus and the development of a regional and national dashboard
  • Recommended that NHSEI works with the South Yorkshire and Bassetlaw ICS to explore opportunities for using AI in pre and post-referral pathways and for advice and guidance management.

“It has been an absolute asset having Nicola Ainscough (Improvement Consultant) working with me on the Outpatient Programme in our ICS and the North East and Yorkshire region. She has been consistently professional, managed to juggle a both complex and hefty workload, required minimal supervision/direction and has impressed the whole regional outpatient team. Nicola had fantastic skills and knowledge around data, measurement and reporting, as well as excellent presentation and report writing skills. It has been an absolute pleasure working with her and I don’t know how I am going to manage without her when the contract comes to an end!”

Juliet Fidorra, Outpatient Programme Lead, South Yorkshire and Bassetlaw ICS