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Chris Phillips and Nik Weaver wrote a paper called The Calkin Algebra has Outer Automorphisms, where they showed that the Continuum Hypothesis implies that the Calkin algebra $\mathcal{B(H)/K(H)}$ has outer automorphisms. See also this paper of Farah, McKenney, and Schimmerling, and references therein; they show that it is relatively consistent with ZFC that the Calkin algebra has only inner automorphisms, and hence the question of existence of outer automorphisms is independent of ZFC.