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.
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
A range of implementation support materials are available on the Patient Initiated Follow Up pages of FutureNHS.
A suite of resources and assets to help promote PIFU to patients and clinicians, including posters, social media graphics, a clinician checklist, and a training video for junior doctors, can be found on the NHS Learning Hub.
Speciality resources
- Setting up patient initiated follow-up services for people with arrhythmia
- Implementing patient initiated follow-up services for people with heart failure
- Guide to implementing patient initiated follow-up and regular surveillance imaging for patients with mild to moderate heart valve disease
- Guide to implementing personalised follow-up for chronic kidney disease in adults
- Guide to implementing personalised follow-up for kidney transplant recipients
- Implementing patient initiated follow-up in dermatology services
- Implementing patient initiated follow-up in adult rheumatology services
- The Neurological Alliance Guidance: Patient Initiated Follow Up in Neurology Services
- Implementing patient initiated follow-up in adult trauma and orthopaedic secondary care pathways
- Ensuring equity of access to care when redesigning dermatology pathways