What are ‘patient initiated follow-up’ appointments (PIFU)?

PIFU describes enabling a patient, or their carer, to decide when they need to see their clinician for a follow-up appointment about their treatment.

This could be when their symptoms or circumstances change.

As well as giving patients timely access to support, this also avoids unnecessary routine ‘check in’ appointments.

PIFU is not a new concept and is known by other names such as open access follow-up, supported self-managed follow-up or see on symptom (SOS).

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

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.

When should PIFU not be used?

PIFU should not be used as a substitute for discharging patients at the end of their care.
To address this, it is important within organisational clinical guidance, to ensure only patients who may require follow-up are placed on a PIFU pathway.

NHS England operational planning

PIFU is part of the outpatients transformation requirements set out in the NHS England operational planning and contracting guidance.

In the NHS Operational Planning Guidance for 2024/25, systems are asked to focus on reducing the overall elective care list size and improve productivity.

The clinical capacity to deliver this improvement will be released from continuing to implement outpatient transformation approaches, including patient initiated follow-up appointments.

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 down to specialty level are also available on our regional Patient Initiated Follow Up (PIFU) FutureNHS Collaboration Platform.

You can also follow the national Outpatient Recovery and Transformation Team on Linkedin.