Topics: Industry insights PIFU
The UK currently has 7.62 million people waiting for care. Balancing waiting list management with maintaining high-quality patient care is an ongoing challenge. Elective recovery requires a multi-faceted approach that addresses various contributing factors. One significant issue is the inefficiency of traditional follow-up processes, which puts added strain on healthcare services. By addressing these inefficiencies, the NHS can create positive ripple effects throughout the system.
The challenges of traditional follow-up processes
Traditional follow-up care relies heavily on routine appointments scheduled at fixed intervals, often requiring clinical teams to make phone calls, send letters, or, in some cases, miss communications entirely. These manual methods are prone to errors, leading to patient stress and resulting in DNAs or redundant appointments, which cost the NHS around £1 billion annually. While this structured approach offers predictability, it doesn't always serve the patient's best interests.
For instance, a young adult hip pathway may take up to two years. During this prolonged period, a patient’s circumstances can change significantly—they might receive care elsewhere, experience improvements, or even see their condition deteriorate. Worsening conditions can lead to more complex care needs and significant discomfort for the patient.
The reliance on the NHS to dictate follow-up schedules limits patient autonomy, turning individuals into passive recipients of care rather than active participants. Patient Initiated Follow-Up (PIFU) has begun to bridge this gap, offering a more sustainable and efficient alternative.
Transform traditional follow-ups with PIFU
PIFU isn't a new concept.
Over the years, it has been known by many names, such as "open access follow-up," "patient-led follow-up," and "open self-referral". A rose by any other name, PIFU, allows suitable patients to initiate follow-up appointments when they need it rather than being automatically called back for an appointment. This saves admin time, allowing staff to focus more on patient care rather than manual management, and frees up clinical resources for those who need them most. On average, each patient and service user on a PIFU pathway saves 1.6 outpatient appointments, with every PIFU request saving over 5 minutes of admin time.
For PIFU to be successful, patients must understand their condition and have the skills and confidence to manage it. In cases where recovery is slower than expected, such as with minor injuries or fractures likely to heal without frequent follow-ups, a blended pathway combining scheduled check-ins with patient-led follow-ups can be highly effective.
However, allowing patients more autonomy naturally raises safety concerns among clinicians. It's not enough to simply pass the baton and hope for the best; a reliable framework is crucial to ensure both self-management and patient safety. This is where digital tools become essential, providing the infrastructure to support PIFU at scale and accelerate its adoption.
Integrating digital technology to accelerate PIFU adoption
Manual PIFU requires patients to actively monitor their condition and initiate follow-ups on their own via phone or email. This leads to significant administrative bottlenecks, such as managing incoming requests and determining appointment availability. These tasks are time-consuming and increase the potential for delays and communication gaps, resulting in a lack of timely care for patients with urgent needs. When integrated with PIFU, digital tools ensure patient care is not left open-ended and help overcome the challenges of its manual counterpart.
Tools such as direct messaging and digital follow-up requests alleviate the burden on booking teams and provide a simpler process for patients, while video provides patients with more convenient access to follow-up care, where suitable.
But one of the biggest drivers for adoption of digital PIFU is the enhanced visibility of workload. Digital reporting and dashboards enable teams to quickly determine how many patients, on average, request appointments. This allows for more accurate capacity planning and minimises concerns from teams becoming overwhelmed by unplanned patient requests, who can now make more informed decisions regarding delivery of care.
Addressing the elective backlog through PIFU
Scaling PIFU across the NHS can significantly impact the elective backlog by aligning clinical resources more effectively with patient needs. By reducing unnecessary appointments and freeing up capacity for urgent cases, the NHS can make meaningful strides toward sustainable elective recovery.
Integrating digital tools into traditional pathways is a crucial step. As a result, the NHS not only addresses immediate backlog challenges but also empowers patients to take control of their care, helping to build a resilient system capable of adapting to future demands.