Patient initiated follow-up

To give patients and their carers the flexibility to arrange their follow-up appointments as and when they need them, NHS England is supporting providers to roll out patient initiated follow-up (PIFU).

PIFU is when a patient initiates an appointment when they need one, based on their symptoms and individual circumstances.

It can be used with patients with long or short-term conditions in a broad range of specialties including dermatology, rheumatology and cancer.

PIFU is not a new concept, and commonly goes by a number of other names including open access follow-up, patient led follow-up, patient triggered follow-up, patient initiated appointments, supported self-managed follow-up, self-managed follow-up, see on symptom, open appointments, open self-referral appointments or patient-activated care.

The approach helps empower patients to manage their own condition and plays a key role in enabling shared decision making and supported self-management in line with the personalised care agenda.

Patient quote: “I understood…that he [my doctor] wouldn’t think, ‘oh, she is just having a bit of a whinge’ – she is contacting me because she needs me, because there is something not working.”

PIFU is part of the outpatients transformation requirements laid out in the 2022/23 Operational Planning Guidance and is a key part of the NHS’ response to the COVID-19 pandemic, helping providers and systems manage waiting lists and to see patients most in need more quickly.

Further resources

Guidance is available to support implementation of PIFU, setting out the main considerations and best practice, drawn from learning from people, clinicians, services, trusts and systems across England.

A range of implementation support materials are available on the Patient Initiated Follow Up pages of FutureNHS.

Speciality resources

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