Wilson N V, Collins R E
Kent & Canterbury Hospital NHS Trust.
Ann R Coll Surg Engl. 1994 Jul;76(4 Suppl):169-71.
Outpatient services are becoming increasingly overburdened and delays for appointments are commonplace. The recent NHS reforms have laid down stricter guidelines on waiting times for hospital services and reorganisation of healthcare provision is necessary in order to meet some of these recommendations. The outpatient service is a case in need. Open access referral for minor cases, endoscopy and vascular assessment, for example, may help to utilise more usefully consultations for new referrals. Follow-up in outpatient clinics should become rationalised with clear objectives being made for investigation and reintervention. The long-term follow-up of patients should rest with their general practitioners. Recommendations have been made for a consultant-based service and more patients are expecting to be seen by a consultant. Until an expansion in consultant numbers is forthcoming patients will continue to experience delays in their management. The current service has scope for improvement and some suggestions are made in this paper.
门诊服务负担日益加重，预约延迟屡见不鲜。英国国家医疗服务体系（NHS）近期的改革对医院服务的等待时间制定了更严格的指导方针，为了满足其中一些建议，医疗服务的重组势在必行。门诊服务就是一个需要改进的例子。例如，对轻症病例、内窥镜检查和血管评估采用开放式转诊，可能有助于更有效地利用新转诊的会诊。门诊诊所的随访应合理化，明确调查和再次干预的目标。患者的长期随访应由其全科医生负责。已经有人建议提供基于顾问医生的服务，越来越多的患者期望由顾问医生诊治。在顾问医生数量增加之前，患者在治疗过程中仍将继续经历延迟。当前的服务有改进的空间，本文提出了一些建议。
