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PIFU is not a new concept and one that PKB knows a lot about. PKB has been supporting patient lead follow-up for many years, supporting and empowering patients to manage their own conditions and enabling shared data and supporting self-management.

PIFU is a way trusts organise care, giving patients and their carers more flexibility over the timing of their follow-up appointments. PKB has been successfully supporting trusts to reduce waiting times and do virtual clinics before the PIFU term came along. You can read more about how here.

Current problems 

  • Patients attending unnecessary appointments

  • Appointments are lengthy and expensive

  • Patients have no control

  • Long waiting times for appointments

PKB Solutions 

PKB supports patients understanding whether they need to have a follow-up appointment by using tools such as: 

  • Symptom tracking 

  • Care planning (with an action plan explaining how to follow up + contact the team)

  • Questionnaires 

  • Monitoring test results and data from patient devices 

  • Messaging a central PIFU booking team 

Workflow

Use cases 

Swansea Bay

Rheumatology team - patients have access to their blood results into their record thus

reducing the need for outpatient appointments, and saving time for more urgent cases. Patients

can also order prescriptions through secure messaging with the clinical team.

Outcomes

  • 75% reduction in face-to-face outpatient appointments (reduced from 4 quarterly to 1 annual appointment)

  • 264 appointments saved from 88 patients (creating capacity) 

  • Patients empowered with the information and tools to:
    - communicate with clinical teams when needed
    - manage medication reviews and prescriptions remotely
    - understand the importance of blood monitoring for their dermatological condition.

Dermatology team - systemic patients normally have blood results 4 times a year. With

the introduction of PKB patients can be seen once a year - they are sent all 4 blood

forms for the year and patients messaging the team with their results in order for them

to obtain their repeat prescriptions removing the need for the appointment.

75% reduction of face-to-face appointments, also reduced a reduction of phone calls, PIFU workflow was able to reduce appointments from every 3 months to once a year appointments. 

Bedfordshire Hospitals NHS FT 

Inflammatory Bowel Disease Service - 1⁄3 of patients moved to a PKB remote pathway where patients initiate the follow-up.

Released 1,100 appointment slots from a patient group of ~600. Empowered patients

with self-management, remote monitoring capabilities and virtual consultations.

“Not only does it save patients having to come into hospital but also allows us to see

when patients flare up, so we can see them within 48 hours rather than generate clinic

appointments.”

East Sussex Healthcare Trust 

Uro-oncology - Patients are actively engaged with the uro-oncology team via PKB and can view blood

test results, complete a symptom tracking questionnaire and read information, which is

then reviewed by the specialist nurse who will feedback either that the results and

symptoms reported are fine, so no appointment is required, or organise an appointment if

a clinical discussion is required. This has resulted in less time required to review blood

tests and frees up appointments.

Key features 

There are key PKB features all services validating waiting lists can use. A list of them is below.

Questionnaires 

Teams can use PKB’s FHIR trigger API to automate sending questionnaires to service users and they can use PKB’s FHIR API to extract completed responses back into their Organisation's electronic patient record (EPR) for review.

Patients can initiate a questionnaire by clicking start questionnaire on their homepage or directly within the NHS App. Once completed the questionnaire can be sent to a professional or team.

New Advanced Questionnaires 

By the end of 2023, organisations will be able to use PKB’s new advanced questionnaire functionality, the features include:

  • Scoring and calculations

  • Branching, allowing patients to complete the parts of the questionnaire that are relevant to them

  • Coded fields, questionnaires can be mapped to clinical codes

  • Patients can save drafts

  • Send questionnaires to patients that aren’t registered or already in your team

Questionnaire templates

Messaging 

  • Patients have access to message their healthcare team (saving time on the phone)

  • The Admin team can triage messages. Either resolving or passing onto another speciality team

  • Universal Messaging is the ability for patients to message clinical and non-clinical teams

  • Team-based messaging allows teams to automatically receive secure messages and consultations as a group rather than as individuals

Library 

  • A wealth of resources

  • Online patient leaflets

  • Support group information

  • Videos

Care plans 

PKB care plans can be used at every stage of a patient's condition journey, below are some of the care plan templates being used and templates that can be created.

Appointments 

  • Appointment letters and appointments sent to PKB via integration

  • Manually entered appointments

SMART goal

Reduce the number of appointments for the ………. team by Sept 2024 (12 months post team go live) from (current appointments) to ( %) by adding all patients to a PIFU pathway (if they fit the criteria), schedule questionnaires to be sent ….. Current appointment rates are (%). 12 months post go live, the team compared appointment rates of patients with and without a PKB record. It is a local NHS priority to add patients to a digital PIFU pathway to reduce waiting lists and to save money.

Case study

Further information

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