Introduction to PIFU:

Guide to Implementing Patient Initiated Follow-Up

18th February 2025

by Jonathan Rapley

The recent elective care reform plan sets out that all NHS Trusts and Boards must offer Patient Initiated Follow-Up (PIFU) as standard in all appropriate pathways. But what is it exactly? And how easy is it for NHS organisations to implement effectively?

PIFU is an approach where patients can initiate their follow-up care when they feel it is necessary, instead of being automatically scheduled for routine appointments. In the context of the NHS, PIFU reduces unnecessary visits, optimises appointment scheduling and allows patients to have more control over their healthcare journey.

Key benefits of PIFU for NHS Trusts and healthcare providers

• Resource optimisation: PIFU reduces the number of unnecessary appointments, enabling clinicians to focus on patients who need urgent or ongoing care. This helps manage clinic workloads, freeing up capacity and reducing waiting times.
• Improved patient flow: By empowering patients to decide when follow-up care is needed, NHS Trusts can optimise the use of healthcare clinics and reduce appointment backlogs.
• Cost efficiency: Reducing unnecessary appointments translates to cost savings. Trusts can allocate resources more efficiently, focusing on patients who require direct intervention rather than follow-up visits that can be initiated by patients themselves.
• Improved patient management: Clinicians have the ability to monitor patient status remotely through digital systems. Patients initiate care when they need it, which allows healthcare providers to assess patient conditions more effectively.
• Timely interventions: By using digital platforms to track patient progress and follow-up requests, healthcare teams can intervene promptly when needed. This improves patient outcomes and ensures continuity of care.
• Streamlined workflows: Automation reduces administrative tasks, allowing clinicians to focus more on patient care rather than on managing follow-up appointments. This enhances overall efficiency in the clinical environment.

How Netcall’s patient engagement portal supports PIFU implementation in NHS Trusts

Netcall’s Patient Engagement Portal is known as Patient Hub. It’s a digital platform designed to streamline patient-initiated follow-up processes within NHS Trusts.

By empowering patients to manage their follow-up care, Patient Hub enhances operational efficiency and reduces administrative burdens.

Key features include:

Appointment notifications: Patient Hub delivers timely appointment notifications directly to patients’ devices, ensuring they receive essential information promptly. This also reduces DNAs (did not attends).

Waiting List Validation: The platform facilitates quick validation of whether each patient still requires to be on a waiting list, enabling NHS Trusts to maintain accurate and up-to-date patient records.

Patient Initiated Follow-Up: Patient Hub supports PIFU by allowing patients to request a follow-up appointment if required. This ensures that follow-up care is timely and handled by a robust appointment workflow.

NHS App integration: The portal integrates seamlessly with the NHS App, providing patients with a unified platform to manage their healthcare information and appointments.

Real-time analytics and reporting: Clinicians and NHS Trusts can access real-time data on follow-up requests, patient status and outcomes. This enables informed decision-making and effective workload management.

Customisable criteria and rules: Netcall’s Patient Engagement Portal, allows NHS Trusts to define the conditions and patient groups eligible for PIFU, ensuring that the process is tailored to meet specific clinical requirements.

Key steps for NHS Trusts to implement PIFU

Step 1: Define PIFU criteria and policies 
NHS Trusts must work with clinical teams to establish which conditions and patient demographics are appropriate for PIFU. Clear guidelines must be set to determine when a patient is eligible to initiate follow-up care. This ensures the process is safe and effective.

Step 2: Integration with NHS systems 
Patient Hub integrates with existing NHS systems such as Electronic Patient Records and Trust Integration Engines. This seamless integration allows for smooth data flow, ensuring patient information is up-to-date and easily accessible.

Step 3: Training NHS admin staff 
Healthcare teams need training on how to use the platform to manage PIFU NHS requests. Clinicians and admin staff will need to understand how to monitor and assess patient progress remotely and intervene when required.

Step 4: Patient education and access 
Patients should be educated about what PIFU works within the context of the NHS and how they can use it to manage their follow-up care. Clear instructions on how to request follow-up care and contact healthcare providers should be provided. Additionally, NHS Trusts can offer support for patients who may require assistance using the technology.

Step 5: Continuous monitoring and feedback 
Using Netcall’s reporting and survey function within the PIFU module, alongside data from other Trust systems, enables NHS Trusts to track how PIFU is being utilised, monitor patient outcomes and gather feedback from both patients and clinicians. This feedback allows Trusts to refine the process over time.

Addressing common questions and concerns about PIFU

Q: How do we know which patients should go onto a PIFU pathway? 
A: NHS Trusts will collaborate with clinicians to define which conditions and patient groups are appropriate for PIFU. These criteria will be established based on medical guidelines and patient needs, ensuring that PIFU is used where it adds value.

Q: How does the technology used ensure patients are ready for follow-up care? 
A: Patient Hub, our patient engagement portal, includes automated notifications and secure communication options. If patients feel they need further follow-up care, they can initiate it themselves through the platform. The system also allows clinicians to monitor patient progress and intervene when necessary.

Q: Can Patient Hub be integrated with existing NHS systems? 
A: Patient Hub integrates with Patient Administration Systems (PAS), Trust Integration Engines (TIE), and other healthcare systems. Data can be exchanged using HL7, FHIR, APIs, or CSV. This  ensures smooth data exchange, reducing administrative overhead.

Q: Does Patient Hub gather information about the patient to help the clinician? 
A: Based on the pathway, the patient can be presented with a questionnaire, designed by the Trust, to ask them questions about their condition ahead of them completing their PIFU request. These questions and answers can be available to the clinician ahead of the appointment, helping achieve a more effective appointment.

Conclusion: The role of technology in supporting PIFU

Implementing PIFU within the NHS – with the support of Netcall’s patient engagement portal, Patient Hub – provides NHS Trusts with a powerful tool. This helps NHS teams to move faster towards transitioning or discharging more of their outpatient attendances to PIFU pathways.

By leveraging technology, NHS Trusts and Boards can scale PIFU effectively, without an unsustainable administrative overhead, offer more personalised follow-up care as standard across all pathways. And this supports the goals of the NHS plan for Reforming Elective Care for Patients.