In 2022 our predecessor Committee was told by NHSE that the area where it has most potential to free up clinical time and see more patients is in outpatients services because “80% of the waiting list is tied 18 NIHR Policy Research Unit on the Economics of Health and Social Care Systems and the NIHR Policy Research Unit on Economic Methods of Evaluation in health and care interventions (NWT0040) 19 NHS England, NHS publishes waiting list breakdowns to tackle health inequalities, england.nhs.uk, 17 July 2025 [accessed 30 September 2025]; NHS England, Waiting List Minimum Data Set (WLMDS) Information, 2025 [accessed 30 September 2025] 20 Q 15 21 Q 47 22 C&AG’s Report, paras 11, 2.21 and 2.23-2.24 9 up by outpatients”.23 NHSE told us at our September 2025 evidence session that outpatients remains the key to solving elective waiting lists, and that it was committed to reducing waiting times by transforming outpatient care. Making use of remote consultations and patient-initiated follow-up (PIFU) aimed to address concerns in the clinical community that patients who need a follow-up might not get one if there was too much focus on reducing the number of follow-up appointments.24 However, the NAO reported that the proportion of outpatient appointments delivered remotely actually declined during the programme from 21.5% in June 2022 to 18.8% in November 2023 against a target of 25%. NHSE originally aimed to increase of PIFU take-up by 5% by March 2023 but the target has now been extended to 2029.25