Oesophageal Stricture Management - Endoscopy v1

Introduction

Patient Initiated Follow Up will put you in control of making an appointment when you need it the most. If your condition is stable, having regular endoscopies can cause unnecessary anxiety, including time taken to travel, park and wait for the appointment, plus the discomfort and risk of the endoscopy itself.

Sometimes, regular endoscopy appointments may not result in any beneficial treatment. In fact, your condition may flare up in between regular booked appointments, and it is during this time that you really do need our input.

For other concerns and conditions, or if you are feeling unwell, your GP will remain your first point of contact.

How does it work?

You have had treatment (both medical and endoscopic) for an oesophageal stricture. You are now at the point where further planned endoscopic treatment is not needed; you should take the acid suppressing medicine as prescribed to keep the inflammation on your stricture under control, which will hopefully prevent it narrowing down again. Some strictures do narrow with time, but there is no way of predicting when or indeed if that will ever occur. For that reason, you have been put on a Patient Initiated Follow Up (PIFU) pathway. This means you will not be booked a follow-up appointment with your clinician, but you can contact us if your swallowing becomes troublesome again. Patient Initiated Follow Up or PIFU is a way of putting you in control of your own care. 

This means that if your condition has flared up or you have symptoms related to your condition, you are able to book an appointment directly with us without needing to speak to your GP for a new referral.

Symptoms to tell us about

It is important that you get in touch with us if you experience any new difficulty with swallowing. Please let us know of your symptoms before they become critical, as although we will book an endoscopy as soon as possible, there will be an inevitable few days delay until the next therapeutic endoscopy list.

If any changes in your home circumstances affect your ability to manage your condition, please do get in touch with us.

When not to use PIFU 

Your PIFU pathway only relates to this specific condition; if you have any concerns relating to other conditions, your GP will remain your first point of contact. If you require urgent medical advice, you should contact your GP, NHS 111, your local Walk-in centre or, in an emergency, your local Emergency Department (A&E).

How long does this pathway last?

You will be told by your clinician how long you will be on a PIFU pathway for oesophageal stricture management, but generally this will be for 2 years. 

Once the time has elapsed, you will be discharged to your GP and we will inform you and your GP of this. If you have any further concerns after this point, it will be necessary to go back to your GP for them to re-refer you. 

Telephone Numbers

To book a patient initiated appointment, please contact the appointments team directly on 0300 555 4567, quoting option 4 for Endoscopy. Let them know you are on the PIFU pathway for oesophageal stricture management, and that you are having symptoms again.

When you telephone the booking team, an appointment will be made for a further gastroscopy and dilatation as soon as possible, usually the next available appointment.

You may also be offered the opportunity to speak with a specialist within the team for initial advice about your condition, for example, a Specialist Nurse.

Can I just turn up at the department?

No. It will not be possible for you to be seen without a pre-arranged appointment.

Cancelling your appointment

It is important that you keep your appointment.  If you cannot attend your appointment, please let us know as soon as possible, as we may be able to offer the appointment to another patient. To cancel your appointment, please telephone the hospital on 0300 555 4567 quoting option 4 for Endoscopy, or you can visit our website and use our on-line cancellation form:- https://www.wwl.nhs.uk/reschedule-an-appointment

Copy letters to patients 

It is usual after your visit to an outpatient clinic that your consultant, doctor or specialist nurse will write a letter to your GP to confirm details of your visit, and any recommendations about your treatment and future management. Please let your hospital doctor or nurse know if you would like to receive a copy of this correspondence or inform the receptionist so this can be arranged for you.

Interpreter services 

The Trust can provide telephone interpreting services and sign language assistance for patients with hearing impairments. The Trust will only use face to face interpreters in exceptional circumstances. Please note that the Trust does not support the use of relatives or friends to provide interpreter services.

Are you an Overseas visitor? 

Hospital treatment is free to people who can demonstrate they have lived in the United Kingdom for the last 12 months.

Chaplaincy & spiritual care 

Sometimes patients and their relatives appreciate someone to support them and to talk to before or after an appointment. Chaplains are there to support people of all faiths and none. If you would like to speak to one of the chaplains, please phone 01942 822324 or ask a member of staff to contact them.