ABSTRACT
Dermatology outpatients were more likely to have chronic conditions than outreach patients. In orthopaedic clinics, outreach patients were more likely to be listed for surgery than hospital outpatients. This chapter shows that significantly longer waiting times at the clinic were experienced by dermatology outreach patients compared with dermatology outpatients and, conversely, by orthopaedic outpatients compared with orthopaedic outreach patients. Outreach clinics present opportunities for general practitioner education, enhanced inter-professional communication and better co-ordination of care. Expanding the outreach clinic commitments of consultants may have serious implications. The opportunity cost of consultants' absence from their hospital base amounted only to a small proportion of consultants' working week. However, this does represent a lost opportunity in terms of time spent potentially seeing more patients in association with training of junior staff. Although there may be some benefits from outreach clinics, widespread development of this model of care may not represent cost-effective use of specialist resources.
