Benefits PKB Care Planning Tool

Benefits PKB Care Planning Tool

Patients Know Best (PKB)’s digital care planning feature empowers patients and streamlines clinical workflows. Hospitals across England use PKB to enhance personalised care, improve patient engagement, and drive efficiency.

Why

Patients and clinicians need an efficient, patient-centred digital care planning tool to improve coordination, enhance engagement, and streamline workflows. Many patients leave appointments with little to no information, yet they are expected to manage long-term conditions or prepare for surgery with no written guidance or support.

PKB provides a comprehensive digital care planning solution that can be used in any hospital and across all specialities. It delivers expert information and support, ensuring patients receive the guidance they need.

What

PKB is a secure, interoperable platform that enables real-time care planning and communication between patients and healthcare teams. Care teams can create multiple individual or generic care plans to support any workflow, including:

  • Perioperative care (prehabilitation, pre-op preparation, post-op recovery)

  • Informed consent

  • Long-term condition management

  • Mental health support

  • Crisis management

  • Remote monitoring

PKB offers remote monitoring, crisis management, and personalised care plans, PKB ensures better health outcomes and reduced administrative burden.

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How

  1. Work with your Success PM to design and tailor generic or individualised care plan templates with PKB’s HTML support. A library of pre-built care plans is available for adaptation to suit your team's needs.

  2. Submit a care plan request. Once your care plan is designed, submit a request form to PKB. The PKB team will create the HTML template within two weeks, allowing up to two iterations for refinement.

  3. Create your own HTML care plans. Alternatively, teams can build their own care plans directly within the PKB coordinator account.

  4. Once added to your PKB site, professionals and patients can add care plan templates to their record with seamless access, sharing and editing abilities. 

 

Key Benefits

Patient-centred access

Patients can view and contribute to their care plans, ensuring shared decision-making and improved self-management.

Multi-disciplinary collaboration

Clinicians across different specialities can access and update care plans in real-time, reducing silos and improving coordination.

Interoperability

PKB integrates with NHS systems (e.g., EPRs, GP records) for seamless data sharing. 

Remote monitoring

Enables proactive care through structured assessments and symptom tracking.

Crisis and long-term condition management

Supports care planning for mental health, diabetes, heart failure, and more, ensuring continuity of care.

Key Features

Embedded information and advice

Add educational content, videos, and links to verified resources, helping patients make informed decisions about their care.

Symptom monitoring

Patients can log symptoms using a RAG (Red, Amber, Green) system, helping them understand when to seek medical help. Ideal for Patient Initiated Follow Up (PIFU) and real-time monitoring of long-term conditions.

Measurements and test results

Live EMR feeds give patients instant access to test results and recent measurements directly integrated into their care plan, reducing the need for appointments and phone calls.

Goal setting and action plans

Define clear steps for patients to manage their condition while ensuring their quality of life is considered.

Professional edit-only sections

Critical care plans, such as end-of-life plans or digital consent forms, can be restricted to professional edits-only sections, maintaining accuracy and preventing unintended changes.

Collapsible sections

Use hyperlink references for phone numbers to enable one-click appointment initiations from the care plan, perfect for PIFU and virtual appointment management.

Customised dropdowns

Configure dropdown lists with colour coding for enhanced visual clarity and quick selection.

Connect devices

Integrate real-time data from wearable and home monitoring devices for a live care plan that is responsive to a patient’s current needs.

Use Cases

Heart Failure at Home

Chelsea & Westminster Hospital’s Heart Failure (HF) team has successfully integrated PKB’s digitalcare planning tools into their workflow, enabling remote monitoring and self-management for patients. PKB’s care plans have been key in supporting symptom tracking, medication management, and patient education. By embedding videos and a traffic light system, patients better understand when to seek help, while secure messaging has improved communication with clinicians. 

  • The digital approach has led to a 48% reduction in readmissions

  • Faster medication optimisation (from 12 months to 30 days)

  • Enhanced efficiency in virtual wards

Read the full case study here

Paediatric Epilepsy Team

The Paediatric Epilepsy Team, who work across both Luton Children and Adults Community Health Services (provided by Cambridgeshire Community Services NHS Trust), Bedford Hospital and Luton and Dunstable University Hospital (both part of Bedfordshire Hospitals NHS Foundation Trust), have been using PKB care plans with their patients and families for over three years, proving them with care plans to record seizures and proving a place to record important information about the child. 

 

“Using PKB allows us a much more timely process of getting crucial information to our parents and carers about medication changes and revisions to emergency care plans via attachments. This is improving patient safety and the service we can provide. For our clinicians, having a single point of access from our clinical system (SystmOne) to PKB is quick. It has allowed more efficient use of nurse time through the messaging functionality, which is fast, efficient and secure.”

Children’s Epilepsy Specialist Nurse, Cambridgeshire Community Services NHS Trust.

The care plans the team uses are

  • Seizure Diary Care Plan - specifically for carers and patients to be able to describe their seizure activity.

  • All About Me Care Plan -  this is used for carers and patients to document all the information they are regularly asked about on admission to hospital removing the need to answer the same questions repeatedly.

  • Chit Chat Care Plan - a plan to support paediatric patients to prepare for their transition to adult services

To read more about the project click here and here.

 

Midlands Partnership Foundation Trust 

MPFT’s Adult Mental Health Services used PKB to achieve PRSB compliance for mental health care plans while improving collaborative workflows. By integrating PKB with the NHS App and Rio, service users can now complete questionnaires and access care plans digitally, ensuring transparency and engagement.

This automation has streamlined data collection, reduced administrative burdens, and improved care consistency. Clinicians benefit from up-to-date patient-reported data, leading to more meaningful care planning.

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To read more about the project, click here.

 

Orthopaedic Virtual Rehabilitation Programme

Hywel Dda Health Board uses PKB to support orthopaedic prehabilitation, providing patients with structured care plans, remote monitoring, and educational resources. Implementing an eight-week virtual programme allows patients awaiting hip or knee replacement surgery to engage in tailored exercises, track symptoms, and access support without frequent hospital visits.

  • Enhances patient empowerment

  • Optimises clinical resources

  • Promotes proactive health management. 

With over 560 registered patients, the programme has demonstrated reducing deterioration risks and fostering better surgical outcomes. 

I feel that PKB has offered patients advice, information and guidance to motivate them to improve their health and wellbeing while they await their orthopaedic surgery and this in turn will improve their future health.

Ben Matthews, Clinical Lead Physiotherapist, Orthopaedic Prehabilitation Service, Hywel Dda University Health Board

To read the full case study, click here.

Further Information

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