Patient Initiated Follow Up (PIFU) puts you in control of making an appointment when you need it and provides you with direct access to support related to your care when required.

Instead of being offered regular clinic visits and routine follow-up appointments with your physiotherapist, people on a PIFU pathway can make their own appointment when you believe you need it.

This is most likely to be if you have:

  • a ‘flare up’ of your musculoskeletal or pelvic health related symptoms that you are struggling to manage yourself
  • your symptoms related to your musculoskeletal or pelvic health condition are worsening
  • if you feel that you are not recovering well or improving

Your physiotherapist will discuss the process with you and your suitability for PIFU and will only put you on the PIFU pathway if you agree to this decision. They will also advise on any symptoms related to your musculoskeletal or pelvic health condition that you need to be aware of and the circumstances for which you should make an appointment.

For musculoskeletal conditions or injuries, you will also be directed to the Self-help page and our NHS Mid and South Essex getUBetter app to help support your recovery from your musculoskeletal problem where appropriate.

Managing My Musculoskeletal Health’ information leaflet is available here or will be given to you by your physiotherapist.

For more information on PIFU, click on the appropriate information leaflet:


After being placed on the PIFU pathway, to book a follow up appointment, you will need to email our Care Co-Ordination Centre (CCC) on provide.askus@nhs.net and include the following information:

      • Your full name
      • Your NHS Number (if known)
      • Your address
      • The service you require (eg Physiotherapy)
      • Preferred appointment type (eg face-to-face or video)

You will then receive a link via SMS, email or call from the CCC asking you to book your PIFU follow up appointment online, if possible, with your physiotherapist.  Once you receive the link you will be able to look through the upcoming free PIFU appointments and book one that works for you, preferably with the physiotherapist you have previously seen if available.  You can call the CCC if you cannot do this via email or access the online booking portal on 03001310111.

If you experience any symptoms which require urgent medical advice you should contact your GP  or phone 111.

Your PIFU plan will last for a specific amount of time which will be explained to you by your physiotherapist. You will be able to book at PIFU appointment if you feel you need one. If you need an appointment after your PIFU timeframe, you will need a new referral which can be done via the online self-referral platform or your GP.

If you feel that you do not require an appointment then you do not need to contact the CCC. Your physiotherapist will explain how long it will last and when you will be discharged.