Direct Access Service - Information for patients

The Plymouth Direct Access service is designed to help support people and their carers in accessing care in a way that works best for them. It is available for people with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and other related conditions. People must have had their illness for more than 1½-2 years and either they or a reliable advocate must be able to contact us when required. It does not work for every person in every situation, but many people find it helps them get the most out of life.

Direct Access is a type of patient initiated follow up or PIFU. Patient initiated follow up is supported by the British Society of Rheumatology, the Royal College of Physicians, and NHS England.

Patients on Direct Access do not get frequent “routine” follow up appointments but contact our Clinical Nurse Specialists whenever advice is needed about their condition or medications. If the patient or advocate has not been in contact with us for 2 years, we make contact with the patient as a safety net and to ensure that problems have not been missed.

When a person on Direct Access makes contacts with us, the Clinical Nurse Specialist and patient decide together how to best resolve the problem. It is often possible for advice over the phone or by email. In appropriate circumstances we may signpost to: other information; other health services; or the joint injection clinic. If a clinic appointment is required with either the Consultant or the Clinical Nurse Specialists, it is scheduled to occur within 2 weeks.

Patients and a supportive carer are asked to watch the short video below prior to going on this scheme, have any further questions answered by a member of the rheumatology team, and are given a wallet sized card and leaflet describing how the scheme works and how to contact us.

This is the May 2022 National Rheumatoid Arthritis Society (NRAS) webinar "What is Patient-Initiated Follow Up (PIFU)?" that you may find interesting.

We value feedback about the Direct Service, both things that work well and ways where it might be improved. Direct Access is not routinely offered for all conditions but if you would like to know more and think it may be appropriate then please ask at your next appointment.

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