Croydon neurology: our experience of patient initiated/expedited follow-up

<h3></h3> Patient initiated follow-up (PIFU) has gained traction since NHS England set out their response to the Covid-19 Pandemic in August 2020. Initial analysis in 2021 identified system difficulties at Croydon University Hospital to fully identify this cohort. In August 2023, we ran 2 analyses - we identified a snapshot of 60 patients who remained on the PIFU pathway (i.e. discharged to PIFU). These patients were on average 7 months into their discharge period (out of 12 months), with 10% of patients initiating a further follow-up appointment, while the other 90% remain on the discharge pathway. Most who initiate a PIFU appointment, do so within 1-2 months of being discharged. We also identified all patients who had requested a patient expedited follow-up (PEFU i.e. triggering an earlier appointment) in January 2022. 6% of all appointments were used for this cohort with a 60% reduction in ED attendance for the 12 months after this appointment compared to the 12 months before. PIFU and PEFU seems to be a safe way of ensuring that the right patient is seen at the right time. Longer follow up is needed to determine the longer-term implications. The systems are still unable to easily identify this cohort.