Giving patients control over their outpatient appointments

Recently, NHS England have issued guidance for their providers and ICBs on patient initiated follow-up (PIFU) for patients with #arrhythmia to support systems and trusts in setting up formalised PIFU in their cardiology services in England.

 HOW PATIENT INITIATED FOLLOW-UP WORKS? Patients are given greater control over initiating their follow-up appointments, so they can be seen quickly when they need to be, such as when their symptoms or circumstances change. Depending upon the condition or pathway this could be via a digital solution that they initiate an appointment and could provide details of symptoms or if really innovative and integrated their PIFU solution could use other remote monitoring solutions to provide clinical data back to the team to assess the need for follow-up appointment or provide self-management advice.

WHY? - usually with NHS outpatient services patients are managed by a clinician through follow-up appointments at routine intervals (Eg. 3, 6 or 12 months). BUT some people might need to be seen sooner than their scheduled next appointment but do not know to get in touch with their clinical team, and even if they do they may not be seen for several weeks. Others may be invited to attend appointments at a time when their condition is stable when they don't need to be seen, potentially causing them unnecessary inconvenience for the patients but taking up precious clinical capacity needed for more urgent patient.

HOW DIGITAL SOLUTIONS CAN HELP - rather than asking patients to email or telephone in which will take up more admin / clinical time, there are so many digital solutions on the market that could provide secure portal for patients to report symptoms and ask for follow-up appointment. All the data is easily accessible for clinical teams, integrated into EPRs and provides a safety net to reduce human error. Alerts could be set up if patients are unstable and need to be reviewed by clinician. This NHS England guidance is useful for both service leads implementing PIFU and innovators to understand it.

A good example is this case study from the Health Innovation Network - South London who supported Guys and St Thomas NHS Foundation Trust with implementing their solution for rheumatoid arthritis patients.

16th November 2023