{"id":32992,"date":"2022-02-03T10:16:03","date_gmt":"2022-02-03T10:16:03","guid":{"rendered":"https:\/\/digileaders.com\/?p=32992"},"modified":"2022-02-03T10:16:03","modified_gmt":"2022-02-03T10:16:03","slug":"why-patient-initiated-follow-up-pifu-could-be-set-to-radically-transform-outpatient-care","status":"publish","type":"post","link":"https:\/\/digileaders.com\/why-patient-initiated-follow-up-pifu-could-be-set-to-radically-transform-outpatient-care\/","title":{"rendered":"Why Patient-Initiated Follow Up (PIFU) could be set to radically transform outpatient care"},"content":{"rendered":"

Delivering patient-initiated follow-up (PIFU) is a major new change to outpatient services laid out in NHS England\u2019s\u00a0Operational Planning Guidance<\/span> and is almost certainly going to be a major component of the Elective Recovery Plan.<\/span><\/p>\n

With two thirds of all hospital appointments taken up with often unnecessary follow-up reviews, patients can find these appointments inconvenient in terms of travel, financial costs and time out of work. These unnecessary appointments also place an exceptional burden on clinical and administrative staff. PIFU aims to reduce this by empowering patients to be partners in the decision about when to have their next follow-up appointment.<\/span><\/p>\n

The target in December, which the majority of NHS trusts missed, was to have 1.5% of all outpatient attendances on a PIFU pathway with the service to be trialled in at least five major outpatient specialties. Against a backdrop of winter pressures, and a burnt out workforce, is it even possible for the NHS to deliver on what are almost certainly going to be tougher targets in the Elective Recovery Plan?\u00a0<\/span><\/p>\n

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Simplifying PIFU through digital<\/h3>\n

While getting any version of PIFU in place is a starting point, to achieve maximum benefit we need to review entire pathways and integrate PIFU at the most optimum point alongside things like digital assessments. PIFU is sometimes viewed as a project in isolation and digital projects are not viewed as part of a wider transformation of the pathway.<\/span><\/p>\n

There is also inconsistency around whether PIFU is really digital or not. Many trusts believe they already have a digital form of PIFU in place because they are using spreadsheets or non-integrated lists to manage the pathway. But this doesn\u2019t solve the issue of being able to automate the service and reduce the time spent on admin. As a result, opportunities to maximise the number of patients suitable for PIFU are missed and the benefits to staff are overlooked.<\/span><\/p>\n

PIFU, incorporated as part of a digital pathway, gives trusts the ability to tailor the messaging, length of service, number of booking requests and provision of additional monitoring requirements. Forward thinking trusts are already scaling PIFU digitally. One is about to rollout digital PIFU in 30 specialities by tailoring solutions to specific pathway requirements. This has enabled those trusts to make a dramatic impact on the way they deliver care and communicate with their patients, giving a better experience of care overall.<\/span><\/p>\n

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The current challenges we face in scaling PIFU<\/h3>\n

One of the barriers to delivering PIFU at scale is the present lack of evidence of just how effective it can be, therefore providing an incentive to implement it. This is in part because there is large variation across NHS trusts about the definition of what PIFU actually <\/span>is<\/span><\/i>.\u00a0<\/span><\/p>\n

A clear, consistent definition of PIFU is essential to determine how many people are suitable for it and to understand and measure the real benefits. PIFU is categorised into four groups, ordered from lowest risk to highest risk:<\/span><\/p>\n