# data[].attributes.headline
Patient Initiated Follow Up (PIFU) and interim self-management of patients in established remission with rectosigmoid-pancolitis Guideline.

# data[].attributes.subject
Patient Initiated Follow Up (PIFU) and interim self-management of patients in established remission with rectosigmoid-pancolitis Guideline.

# data[].attributes.body
This guideline, developed by the Gastroenterology Department at Milton Keynes University Hospital NHS Foundation Trust , provides a structured framework for the Patient Initiated Follow Up pathway in adults with Ulcerative Colitis .

The document supports a shift towards personalised, patient-centred care and shared decision-making within chronic disease management. Traditional fixed-interval follow up models often fail to align with periods of active disease or remission. PIFU empowers stable patients in long-term remission to initiate follow-up when clinically indicated such as during a flare or change in symptoms thereby improving access to specialist input and optimising healthcare resources.

This approach aligns with IBD UK Standards (2019), particularly Section 4: Flare Management.

Patients are supported to develop the knowledge, skills, and confidence to self-manage their condition through education, written materials, and digital tools such as the iOWNA app.

Only patients meeting defined stability criteria (e.g. faecal calprotectin <50 µg/g, no steroid use for ≥2 years, not on immunomodulators/biologics) are considered for the pathway.

Routine colonoscopic surveillance is maintained according to individual cancer risk stratification, ensuring ongoing monitoring even in the absence of symptoms.

Interdisciplinary Collaboration: Effective communication between gastroenterologists, IBD specialist nurses, GPs, and patients is essential. Clear documentation, including PIFU initiation letters and management algorithms, ensures continuity of care.

Self-Management Framework

The guideline outlines a structured stepwise flare management protocol, enabling patients to:

Recognise early flare symptoms via iOWNA assessment tools.

Optimise mesalazine therapy and initiate topical treatments as required.

Implementation of the PIFU model promotes:

1. Enhanced patient autonomy and engagement in long-term condition management.

2. Improved efficiency within outpatient gastroenterology services.

3. Reduced unnecessary hospital visits, allowing prioritisation of patients with active disease.

4. Maintenance of clinical safety through structured surveillance and multidisciplinary oversight.

# data[].attributes.headline
 Evaluation of the efficacy of digitally-enabled patient-initiated follow up (PIFU) pathways for ulcerative colitis, supporting patient self-management

# data[].attributes.subject
 Evaluation of the efficacy of digitally-enabled patient-initiated follow up (PIFU) pathways for ulcerative colitis, supporting patient self-management

# data[].attributes.body
Digitally enabled Patient Initiated Follow-Up (PIFU) pathways can significantly empower patients with Ulcerative Colitis to manage their condition more effectively. By improving confidence and reducing reliance on helplines, this model demonstrates both patient empowerment and resource efficiency, representing a practical shift toward self-directed, digital first IBD care.

# data[].attributes.attachment_link.description
Verifying you are human. This may take a few seconds.

# data[].attributes.headline
Audit of Impact of a Clinician & Patient Support Tool in a Nurse-led Clinic for Inflammatory Bowel Disease Service at Milton Keynes University Hospital

# data[].attributes.subject
Audit of Impact of a Clinician & Patient Support Tool in a Nurse-led Clinic for Inflammatory Bowel Disease Service at Milton Keynes University Hospital

# data[].attributes.body
This study explores the impact of iOWNA, a clinician and patient support tool, on Inflammatory Bowel Disease care pathways at Milton Keynes University Hospital. Over a 9-month audit, the tool saved 14,735 minutes of nursing time, replaced 232 in-person appointments, and generated £16,704 in cost savings. It also boosted Patient-Initiated Follow-Ups and improved both patient and clinician experience. The findings highlight how digital solutions can streamline chronic disease management, reduce NHS backlogs, and empower patients for better self-care key steps toward a more efficient, patient-focused healthcare system.

# data[].attributes.attachment_link.title
Audit of Impact of a Clinician & Patient Support Tool in a Nurse-led Clinic for Inflammatory Bowel Disease Service at Milton Keynes University Hospital

# data[].attributes.attachment_link.description
Objective This audit examines the impact of a recently-commissioned clinician and patient support tool, on care pathways for Inflammatory Bowel Disease patients at Milton Keynes University Hospital, on follow up appointments (including PIFUs), associated cost savings and patient and clinician engagement and experience. Design The audit was conducted using a retrospective, consecutive case review of appointment records of patients enrolled onto the iOWNA platform during a 9-month audit period. Patient-clinician interactions were categorised depending on whether an appointment was saved and an appropriate nursing time saving logged. Data on both cost savings and PIFU numbers were also collected from the trust. Quantitative and qualitative feedback of clinician and patient experience were captured. Results The deployment of iOWNA resulted in a total time saving of 14,735 minutes across the audit period, of which 9,280 minutes comprised savings on in-person appointments, representing 232 appointments saved. The cost savings for these 232 replaced appointments totalled 16,704 GBP. The audit period also saw a statistically significant (p<0.01) increase in the number of Patient-Initiated Follow Ups (PIFUs). Patient and clinician surveys reflected positive experiences of the new care pathway among all service users. Conclusion The results of the audit demonstrate the important role digital tools can play in transforming existing care pathways to deal with the widespread challenges facing the NHS following the COVID-19 pandemic, with annual savings of over 345 million GBP for the NHS if the appointment cost savings demonstrated in this audit were replicated alongside a 5% reduction nationally in outpatient attendances. What is already known on the topic What this study adds How this may affect research, practice or policy ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Oxford A NHS Research Ethics Committee confirmed that as a clinical audit, ethical approval was not required for this study. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present work are contained in the manuscript

# data[].attributes.body
I felt incredibly proud to disseminate my work at the British Society of Gastroenterology (BSG).

It was a fantastic opportunity to showcase the effort, research, and dedication that went into this project. Standing among peers and experts in the field, I was reminded of the importance of collaboration and innovation in improving patient care. Sharing my findings not only validated the hard work but also sparked meaningful discussions that could lead to real-world impact.

# data[].attributes.body
This PowerPoint presentation demonstrates how our department at Milton Keynes University Hospital leverages iOWNA to improve Inflammatory Bowel Disease services. It highlights challenges in traditional care, the integration of Patient Initiated Follow-Up (PIFU) pathways, and how iOWNA empowers patients with digital tools for self-management. Explore objectives, benefits, educational resources, patient feedback, and evidence from recent audits and publications.

# data[].attributes.body
This illustration outlines the process of patient assessment and guidance, emphasising the provision of education on blood monitoring requirements to support safe and effective care.

# data[].attributes.headline
As part of the patient education and consent process, each patient will receive a comprehensive information package that includes:

# data[].attributes.subject
As part of the patient education and consent process, each patient will receive a comprehensive information package that includes:

# data[].attributes.body
1. A 3-minute educational video by the whole team including the IBD Lead gastroenterologist explaining the purpose, benefits, and potential risks of the prescribed medication.

2. A Crohn’s & Colitis UK (CCUK) information leaflet, providing detailed written guidance and support resources. We also incorporated leaflets that we had produced within the trust.

3. A set of consent questions tailored to the specific drug, designed to confirm patient understanding and ensure informed decision-making.

This approach ensures patients are fully informed, promotes shared decision-making

# data[].attributes.headline
A Milestone Moment: Disseminating My Work at BSG

# data[].attributes.subject
A Milestone Moment: Disseminating My Work at BSG

# data[].attributes.body
This was an incredible opportunity to connect with professionals, exchange ideas, and highlight how digital solutions can empower patients and transform outpatient care. Sharing this project at such a respected platform was a proud milestone in my professional journey.

"Evaluation of Digitally-Enabled Patient-Initiated Follow-Up (PIFU) Pathways for Ulcerative Colitis: Supporting Patient Self-Management"

Focuses on assessing the impact of digital tools in managing Ulcerative Colitis (UC). It highlights the challenges UC patients face in self-managing their condition, which can lead to worsened symptoms and increased healthcare demands. The study evaluates the efficacy of PIFU pathways facilitated by the iOWNA platform, aiming to empower patients through access to information and self-assessment tools. Preliminary findings suggest that patients on digitally enabled PIFU pathways show reduced reliance on IBD helplines and healthcare services, with surveys indicating increased patient confidence and control over their condition. The poster emphasises the transformative potential of these digital pathways in enhancing patient outcomes and reducing healthcare resource utilisation, while also noting the challenges of patient engagement and the importance of ongoing digital literacy and education. Future directions include further integration of PIFU pathways with electronic health records and personalised support to maximise effectiveness and scalability.

# data[].attributes.body
The feedback highlights the positive impact of an IBD related patient portal designed to support patients and streamline care. Users found the app very easy to use, with information that was logical, accessible, and reassuring. Features such as videos and clear pathways for help were praised for making the experience informative. Patients appreciated the support advice, including guidance on medications like Azathioprine, and valued the convenience of having the app available on their mobile devices whenever needed. Forms were simple to complete with intuitive options like buttons and sliders, contributing to a sense of involvement and empowerment. Overall, the app is seen as a practical and effective tool for improving patient confidence, accessibility to information, and overall care management.

# data[].attributes.body
Patient feedback shows overwhelmingly positive experiences. The majority of respondents reported being very satisfied with their care, with scores consistently high across all categories. Most patients strongly agreed that they received clear communication and felt supported throughout their treatment. Ratings on a 0–10 scale were excellent, with 80% giving a perfect score of 10. Overall, the feedback reflects a strong commitment to quality care and patient satisfaction.