PKB helps deliver Patient-Initiated Follow-Up (PIFU) by providing a digital platform that enables patients to easily message their teams to request appointments if needed, rather than being booked into routine follow-up slots that may not be necessary.

PKB believes True PIFU is patient-led: patients contact their team when they notice symptom changes or deterioration, with support provided to monitor these changes themselves and to explain to patients what they should expect and when it is appropriate to get in touch.

PKB supports both PIFU and enhanced models with self-monitoring.

• Evidence of Impact: PKB automates the capture of critical metrics, such as the typical 75% reduction in face-to-face appointments observed in organisations using PKB for their PIFU solution. 

• Clinician Confidence: By using PKB’s remote monitoring and RAG-rated care plans, clinicians can safely manage PIFU patients without fear of them dropping off the list.

• Equality of Access: PKB’s integration with the NHS App ensures high accessibility, meeting the document’s requirement for inclusive digital tools.

• Sustainability Goals: PKB tracks avoided travel miles, directly supporting Organisations Green Plans and carbon reduction targets.

• Up to 75% reduction in unnecessary follow-up appointments

• Significantly reduce phone calls and admin overhead

• Promotes patient empowerment and self-management

• Supports remote monitoring and digital escalation pathways

Teams can use PKB appointment management, where patients message the team to request an appointment. The team then books the appointment in their PAS, which sends the appointment details and letter to their PKB record. 

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Patients have access to their blood results into their records, 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.

• 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.

Systemic patients typically 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 message the team with their results in order for them to obtain their repeat prescriptions, removing the need for the appointment.

75% of face-to-face appointments were reduced, as were phone calls. PIFU workflow was able to reduce appointments from every three months to once a year. 

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.”

Patients are actively engaged with the uro-oncology team via PKB and can view blood test results, complete a symptom tracker questionnaire and read information, which is then reviewed by the nurse who gives feedback either on the result and symptoms are acceptable, meaning, no appointment required, or the they organise an appointment if clinical input is needed. This has resulted in less time reviewing blood tests and freeing up appointment slots.

• Goal: Achieve a net reduction in routine outpatient follow-up volume by 20% within 6 months.

• Rationale: The strategy targets a reduction of 0.8 to 1.8 avoided appointments per patient moved to a PIFU pathway.

• Measurement: Follow-up appointment volume tracked against the pre-implementation baseline.

• Goal: Shift 40% of patient-initiated requests from telephone/analogue routes to PKB digital messaging within the first 4 months.

• Rationale: Reducing administrative overhead and telephone tag is a key non-cash-releasing benefit.

• Measurement: Percentage of requests received via PKB vs. traditional phone lines.

• Goal: Ensure 100% of flare-up escalations sent via PKB are triaged by a clinician within 48 hours.

• Rationale: Rapid digital escalation is vital for maintaining safety nets and clinician trust.

• Measurement: Response time audit using PKB message timestamps.

• Goal: Attain a 60% digital registration rate on PKB for all patients assigned to a PIFU pathway by the end of Year 1.

• Rationale: High registration ensures the digital pathway is the primary, most efficient route for the population.

• Measurement: PKB registration data filtered by the specific PIFU patient cohort.

Before deploying PKB, the organisation should focus on these pre-metrics to establish a baseline to support their outcomes. 

• Follow-up Activity: Total volume of outpatient follow-ups (OPFU) and existing follow-up-to-first ratios.

• Administrative Effort: Total hours spent by admin staff managing routine follow-up bookings and manual phone inquiries.

• Capacity Waste: Current DNA (Did Not Attend) rates for routine follow-up slots that could have been repurposed.

• Patient Empowerment: Baseline Patient Activation Measure (PAM) scores to determine how confident patients currently feel managing their conditions.

There are key PKB features of PIFU.

• Patients message their team if they need an appointment

• The Admin team can triage messages, booking them an appointment

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• Patients complete a Questionnaire explaining why they need an appointment

• Include all relevant information the team need

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• Appointment letters and appointments sent to PKB via integration

• Manually entered appointments

• PKB PIFU solution: Where and how PKB supports organisations to deliver PIFU pathways

• Dermatology in Swansea case study: Transforming the face of traditional dermatology services

• Inflammatory bowel disease service case study: Better care leads to savings in Inflammatory Bowel Disease

• Appointment Management: with PKB