Ahmad Khwanda, Kevin O’Gallagher, Madalina Garbi, Stefan Karwatowski, Edward Langford
Introduction
The increasing burden on healthcare services, combined with effects of austerity, has placed the National Health Service (NHS) under pressure to achieve ever-greater efficiency, while improving the quality of service. An example of the increased demand is that the total number of hospital outpatient appointments in England has increased steadily by more than 3% per annum since 2011.1,2
The government, in the 2010 white paper, set out a redesigned pathway endorsing clinically led services based on more effective dialogue and communication between general practice and secondary care.3 Thus, integration of healthcare services has be