Every encounter must add value for the patient.

Outpatient services will be designed around the specific needs of the patient.

Face-to-face meetings as close to home as possible (satellites or other sites).

Timely access to outpatient services, with the right patients being seen by the right people, at the right time and in the right place.

Patients are fully engaged in their treatment in a way that enables them to take responsibility for their own care whenever possible.

Patients will not be brought back for unnecessary appointments.

Care will be delivered in appropriate environments that are accessible, comfortable and respect individual privacy.

Secondary care expertise into community/primary care.

The workforce will be used effectively and flexibly to deliver safe, efficient and cost-effective care.

Clinical teams will be fully engaged in the management of the service and will use clear metrics to measure service delivery and improvement.

Advice should be readily available to GPs from secondary care to avoid the need for unnecessary referral.

Evidence-based patient pathways will be developed for the most common conditions that span primary and secondary care.

Technology should support alternative models of care and promote better communication across primary and secondary care.

Maximise use of technology (provide virtual clinics when clinically appropriate).

Design whole end-to-end pathways, which should be lean.

Different models for one-stop procedure-based activity and long-term condition management.

Cross-specialty working for multiple comorbidities / high-risk stratified patients.

The service will promote a culture of self-help and safe discharge.

Information and communication systems will be used effectively to ensure relevant information on a patient's care is available where and when it is needed for patients and clinicians.

Variation in core processes will be reduced in order to improve clinical and service quality.

Core support processes and services will be aligned to deliver care in ways that minimise avoidable delays and non-value adding activities.