200,000 hospital trips avoided in Cheshire and Merseyside

More than 200,000 unnecessary hospital appointments were avoided across Cheshire and Merseyside last year as hospitals gave patients greater flexibility on when they attend outpatient hospital appointments. 

Patient Initiated Follow-Up (PIFU) allows people to book an appointment when they need one instead of having a routine follow up.

Patients are also receiving specialist advice in their GP practices thanks to Advice and Guidance, which allows GPs to access specialist clinical advice from hospital clinicians instead of the patient automatically needing to visit their local hospital.

NHS Cheshire and Merseyside’s Outpatient Transformation Programme team has been working closely with health and care providers across the area to make it easier for patients to take control of their appointments and reduce the need to go into hospital.

More than 90% of outpatient departments across the region are now offering patients specialist advice and PIFU pathways in 14 priority specialities, which also frees up more appointments for those who need them most and goes some way to reducing the number of missed appointments.

Figures for 2023 show that 119,554 patients were able to choose when they needed a follow-up appointment, while there were 427,411 specialist advice requests from GPs to hospital clinicians, which prevented 90,527 hospital visits.

Some of the work carried out to achieve these results has included establishing working groups for Advice and Guidance and PIFU with representatives from each hospital trust. Policies have been produced outlining the expectations on trusts and a performance dashboard has been developed to monitor progress. Webinars and meetings have taken place to discuss processes and share learning and best practice so trusts can support each other to develop their services. There has also been engagement with patients to understand their experiences in order to inform and develop services further and a clinician-based communications campaign to promote the benefits.

We have seen great results from some of our hospital trusts which has been achieved through a high level of clinical engagement and pathways being co-designed with patients. Trusts have also put clear procedures in place for all staff, shown that they are consistently reviewing data to improve services and have collaborated with colleagues in primary care and the community to ensure services meet their needs.

Mother-of-two Emma Hurst, from Chester, used PIFU when her daughter was referred to the specialist team at her local hospital.

She said:


The patient-initiated follow-up pathway means that I'm in control of my daughter's appointments, if there's a flare up in her condition or her symptoms become unmanageable, I can telephone or email the specialist team to make an appointment.

I think this is great because it means that I don't have to travel or take my daughter out of school, and it also means that the team at the hospital aren't wasting their time on an appointment that's not necessary. I think it's a personalised and flexible way for me to be in charge and look after my daughter's care going forwards.”

Professor Rowan Pritchard-Jones, Medical Director at NHS Cheshire and Merseyside, said:


“We know patients don’t always need or want to go into hospital for their outpatient appointment which is why we want to empower them to manage their scheduled appointment in a way that suits their lives.

“Introducing these options effectively is helping us to deliver personalised care and means patients only go into hospital when they really need to.”