Patient initiated follow-up (PIFU)

In partnership with the

What is PIFU?

If your condition is stable and you don’t need a routine follow-up appointment, we will place you on a Patient Initiated Follow-Up (PIFU) pathway.

This means you are in control of arranging a follow‑up appointment if you feel you need one, rather than being given a regular, scheduled review.

PIFU gives you:

Reassurance – you can get help if and when you need it
Choice – you don’t have to come to appointments you don’t need or want
Better service – it helps us keep waiting times shorter

Who is PIFU for?

What you need to know about your PIFU pathway

How long your PIFU review period is

This is usually between 1 and 6 months, depending on your condition, but your clinician will tell you during your appointment and in your clinic letter.

You should contact us if:

Your symptoms significantly worsen
Your condition fails to improve as expected
Your symptoms begin to interfere more with your daily activities
You have questions or need additional support with your self‑management plan

How you can make an appointment

If you need a follow-up appointment, please click here for contact details for your local Circle service – you can call or email us to arrange this.

Important to know

Your PIFU pathway is only for the condition we have already seen you for, and
It is only valid for the timeframe we give you.

If you develop a new problem, or your PIFU period has ended, you will need a new referral so we have up-to-date information about your condition.

When to seek urgent medical advice

Please contact your GP or NHS 111 urgently if you develop:

Unexplained weight loss
Night pain that does not improve with rest
Loss of bladder or bowel control
Numbness or weakness around the "saddle area" (perineum, buttocks, groin, and inner thigh area)
Fever, redness, or swelling in a joint
Severe pain that is rapidly worsening

If you think you need immediate help, go to A&E or call 999.

For those with skin conditions, you should seek urgent medical attention (usually by going to A&E) if you notice:

Sudden worsening of your skin condition along with fever, nausea or vomiting
A new, quickly spreading rash which is different to your underlying skin condition
A new rash which does not disappear when you press a glass over it, alongside feeling unwell or having difficulty passing urine