Jacob Haddad, co-founder of AccuRx, explores why the health system should rethink its current approach to patient initiated follow up (PIFU), in order to increase supported self-management and make patients greater partners in their care.

Read any article or thought-piece on PIFU and it won’t be long before you see the term ‘empower’ or ‘empowerment’. Yet still, today’s PIFU solutions are predominantly framed as patient-initiated booking systems, meaning patient ‘empowerment’ quickly becomes shorthand for the ability to book an appointment directly with a service.

But it doesn’t really transfer power to patients if they have to repeatedly call a phone line to book their appointment, or if that appointment isn’t readily available because there aren’t empty slots available, or if they’d actually receive the care they need quicker and more effectively another way. Given the lack of technical infrastructure and capacity for training, it’s completely understandable that overwhelmed services have turned to the known method of phone lines to implement PIFU, but we know this can result in a poor patient experience, and can also be inefficient for staff, ultimately causing delays in treatment time.

This is why the health system should rethink its current approach to PIFU.

Real patient empowerment

Real patient empowerment comes through the patient’s ability to communicate directly, easily and in a timely manner with an experienced clinician who provides them with the right means of personalised care. The NHS’s ambition of increasing supported self-management through PIFU and making patients greater partners in their care hinges on this ability to communicate.

Real empowerment also means enabling patients to initiate a dialogue directly with their care team. That way, they can quickly and easily make contact when they need to, and receive the clinical information they need to make informed or shared care decisions. This accessible point of interaction is what makes patients – particularly those more vulnerable – feel confident and in control of their care.

This will also save more time for staff who will be able to more easily communicate with their patients and the rest of their healthcare teams, and ultimately, result in clearing the backlog more efficiently.

Lessons learned

NHS providers should use PIFU to open a digital channel of communication which allows patients to get the specialist support or advice they need, without needing to book an appointment at all if it’s not needed. This would enable patients and staff to communicate easily outside the appointment, before a follow-up is even booked. And this should be available to all patients who it’s appropriate for, not just the 5% target for March 2023, with automated safety netting for patients who haven’t been in touch for extended periods.

Lessons learned from primary care, the vaccination programme, and hospital teams around England show that seamless communication can:

  • Transform the experience of care for patients
  • Save staff time
  • Ensure more patients receive care quickly and effectively