As more patients from diverse backgrounds access NHS outpatient services, delivering fair and timely care has become increasingly challenging. Differences in language, culture, and health-related needs contribute to inequalities, missed appointments, and patient dissatisfaction. These issues waste valuable resources such as staff time and funding, while also increasing waiting times and reducing the overall efficiency of the healthcare system.

Addressing this requires coordinated action across three key sectors: governance, NHS organisations and local communities, and NHS outpatient departments. The solution should be grounded in people-centred design, using primary data to understand the real needs, lived experiences, and hidden barriers faced by patients. Missed appointments represent only the visible “tip of the iceberg”; beneath them lie systemic and personal factors that limit access to care. By integrating digital transformation with in-person solutions, the system can better accommodate diverse needs—for example, through self-management tools, co-designed treatment plans, culturally accessible health education, targeted staff training, and extended service availability. Such an approach has the potential to reduce barriers, promote inclusivity, and build a more equitable healthcare system that works for everyone.