Case Study

Patient-initiated follow up in Leicester, Nottinghamshire, Norfolk and Norwich

Three trusts have substantially reduced unnecessary outpatients appointments, overdue referrals and waiting lists through patient-initiated follow up.
Digital Health, Norfolk and Norwich University Hospitals NHS Foundation Trust, The Royal College of Ophthalmologists

10 November 2023


Patient-initiated follow up, or PIFU, allows patients to decide when and if they need a follow-up appointment for their condition or associated symptoms. Through shared decision-making and assessment with clinicians, suitable patients are moved to PIFU to allow them to self-manage and get back in touch when they feel they need to.

PIFU aims to empower patients to decide when they need to be seen. It can help reduce unnecessary hospital visits; save time and costs on travelling to appointments; and promotes self-care. For hospitals, it allows better use of capacity, has the potential to reduce DNAs (did not attend), and to improve patient experience.



University Hospitals of Leicester (UHL): Reducing elective backlog and long waits for patients

In Leicester, services are implementing a digital, triage-first approach to PIFU, through Accurx. Patients are given a link that allows them to instantly message their care team when they have a query or need support, meaning they are able to make a request at any time instead of having to call during office hours to request at appointment. So far, more than 5000 patients who have been moved to PIFU have been sent the digital link applicable to their service. 

When patients have a query, they are able to submit their request through a simple online form that separates out admin from medical requests. This is helping teams to reduce phone call volumes and easily triage incoming medical and admin PIFU requests. Many of these requests can be resolved without the patient having to be seen back in the clinic, thereby helping to reduce unnecessary appointments. Ultimately, it is also improving patient experience by allowing them to make contact with their service at a time that is suitable to them, instead of experiencing a busy phone line.

Siobhan Favier, deputy chief operating officer at UHL, said: “This partnership with Accurx illustrates the impact that tech which enables better communication with patients can have on the elective backlog.” UHL is delivering this work through the Innovation Partnership with Accurx.

Details provided by Accurx. For more information please contact the team at University Hospitals of Leicester.

Norfolk and Norwich University Hospitals NHS Foundation Trust: Improving outpatient capacity

After one year, PIFU has avoided more than 29,000 unnecessary outpatients appointments at Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH). There are 31,862 patients with chronic conditions or who have had surgery or treatment, on a PIFU pathway, of whom 2,389 (7 per cent) have booked an appointment, saving at least 29,473 appointments in one year and freeing appointments for those who need them most.

Through PIFU, patients have been able to decide whether they need an appointment and request it via the DrDoctor app at a convenient date and time. Patients have welcomed the changes, with an average patient feedback rating of 4.2/5.

Chris Cobb, chief operating officer at NNUH, said: “Our partnership with Infinity Health and DrDoctor is already having a positive impact on patients and clinicians. Patients tell us that they feel in control of their condition and can communicate with their clinical teams more easily.

Read the full article on the NNUH website.

King’s Mill Hospital: Developing PIFU in ophthalmology

In 2020, King’s Mill Hospital, part of Sherwood Forest Hospitals NHS Foundation Trust, had 8,000 overdue referrals. Since the development of its PIFU offering, the hospital’s ophthalmology unit has reduced its overdue referrals by approximately 80 per cent to 1,600, with no referrals more than 13 weeks overdue. The unit has saved 1,957 outpatient appointments in total through PIFU alone, averaging around 104 appointments each month. These appointments can be repurposed for more complex cases while also saving patient time.

Patients have been happy with the shift, and the unit received no complaints. The sense is very much that patients have felt empowered with the extra responsibility, and they know there will be space if they need to be seen quickly.

Feedback within the unit has been positive too. The development of PIFU has brought structure to the ‘open appointment’ process, aligning patients, staff and management on the requirements and benefits of running this offering.

The full article is available on the Royal College of Ophthalmologists website.