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NHSE and NHS Improvement have published guidance on Patient Initiated Follow-up (PIFU) in adult rheumatology services in consultation with our Clinical Affairs Committee. This provides adult rheumatology services with the tools to establish safe and sustainable models of care, irrespective of whether they currently have PIFU processes in place or not.


PIFU is not a new concept for rheumatology services, as many already offer open-access follow-up and annual reviews linked to their nurse-led advice lines. Both the NHS Long Term Plan and 2021/22 Priorities and Operational Planning Guidance emphasise the importance of personalised follow-up and PIFU, and provide an opportunity for services to formally manage the PIFU process where informal arrangements currently exist.


Prior to 2020, many rheumatology services were already experiencing significant capacity pressures, and the pandemic has led to significant backlogs. PIFU, alongside clinical waiting list reviews, remote consultations and digital solutions, can be a key tool for providers in their COVID-19 recovery. The reduction of unnecessary follow-up appointments will allow clinicians to prioritise patients with urgent clinical need and address appointment backlogs.


The guidance is available on NHS England and NHS Improvement Future NHS for clinicians, service managers and commissioners.


Visit FutureNHS to register and request access


Read the guidance