This approach has been intrinsic to our ambitions for the past 20 years: delivering consultant-led outpatient care in local GP and community settings. It’s what we do – and it’s what patients consistently tell us they want: high-quality NHS healthcare, delivered closer to home, with shorter waiting times.
While the plan’s emphasis on reducing pressure on hospitals by shifting care into community pathways isn’t new, what’s different now is it has the national spotlight. There is a clear opportunity to scale proven models like ours – not just to relieve hospitals, but to genuinely transform access, experience and outcomes for patients.
When done well, bringing care into the community is more efficient, personal and sustainable. Our patient feedback shows that 96% would recommend our service to family and friends – not just because of convenience, but because the quality of care meets or exceeds their expectations.
We work closely with our local communities and GP practices (including through sharing electronic patient records) to identify the services most valued locally – and then we deliver. Practices that use DHC Outpatients most frequently have a 12% lower referral rate than our ICB average and substantially lower than their comparable neighbouring practices. This is because when GPs know they can easily access a high-quality, responsive service, they don’t need to refer as a precautionary or standardised approach. Instead, they have the flexibility to monitor symptoms or try initial treatments in the knowledge that timely, specialist support is readily available if needed. This reassurance of having effective backup leads to more thoughtful referral decisions, reducing unnecessary appointments and overall system pressure – a clear example of how accessible, quality care leads to better value and outcomes. It’s about quality not quantity.
For the plan to succeed, we need a connected system that puts patients at the centre of this change. Care should be organised around the patient – not the organisation.
This means delivering seamless healthcare across primary, community and secondary care – breaking down silos and shifting towards a proactive, patient-centric approach. One that anticipates need, enables faster access and provides the right support in the right place at the right time.
For true transformation, services need to collaborate around patient needs, rather than competing for funding or activity.
We need the elective care funding model to alter so we can drive further change for patients. A revised model should:
It’s encouraging to see the national conversation finally aligning with the work that has long been happening on the ground in places like DHC. However, we’ve heard similar ambitions before – and too often, they’ve fallen short of delivery.
I very much hope that this time, the Government finds ways to break through the pressures on hospital services and the long elective waiting lists. And with the right investment, workforce planning and data sharing infrastructure put in place, we stand ready to play our part.
We know this model works. Our patients know it works. Now is the time to act – to take it to the next level and make it truly sustainable.
At DHC, we deliver over 4,000 outpatient appointments each month across multiple neighbourhood health centres, including:
In addition, we’ve recently opened a new site at Elizabeth House Medical Practice serving patients in the North Tandridge area. We also offer ultrasound services at nine sites across Surrey, with eight of these being in GP practices. Our outpatient services are already well embedded within each of our prototype neighbourhoods, making us ideally placed to support the 10-Year Plan.
Our model brings elective care for a wide and growing number of specialities into smaller, more familiar settings that are easier to access – especially important for those with mobility challenges, caring responsibilities or limited means to travel.
My name is Michael Arnaud and I am the CEO of DHC GP Federation. I have over 28 years of experience working alongside GPs and in this blog I discuss my thoughts on how we can bring healthcare services closer to patients’ homes.