P092 Beyond the acronym: optimizing dermatology resources through patient-initiated follow-up

Abstract

Patient-initiated follow-up (PIFU) is encouraged within the NHS as part of the 2025/26 elective reform plan to optimize outpatient resources and clinical capacity while supporting patient self-management. National guidance from NHS England and the BAD outlines strict eligibility, safety netting and documentation requirements. We evaluated compliance with PIFU use at our centre against these standards and identified areas for service improvement. PIFU is offered when a condition is benign and well controlled, for a clinician-defined duration, with written information provided to patients. This retrospective audit aimed to assess compliance with BAD 2021 guidance for PIFU by evaluating allocation appropriateness, documentation quality, pathway utilization and activation outcomes. Anonymized electronic records were reviewed for demographics, diagnosis, PIFU eligibility and duration, documentation and activation outcomes. Between 6 January and 5 September 2025, 164 patients were placed on PIFU; 60% were female and the mean age was 41 years. The mean PIFU utilization rate was 20.5 patients per month. The most common duration was 6 months (43.4%). Appropriate allocation occurred in 86% of patients with nonmalignant dermatoses encompassing inflammatory, autoimmune, infective and genodermatoses. Documentation of PIFU status and duration was excellent (98.2% and 92.5%, respectively), whereas documentation of provision of patient information leaflets was low (6.7%). PIFU activation occurred in 6.1% of cases, all clinically appropriate, with 26% discharged to primary care following completion. Clinician survey feedback supported effective implementation, with 58.3% reporting extreme confidence in use of PIFU and 100% recommending wider departmental adoption. PIFU functioned safely when applied to appropriate patients; however, gaps in eligibility adherence and patient communication represent governance risks that may limit optimization of outpatient resources and clinical capacity. We aim to strengthen the utilization of the pathway with clinician education and appropriate patient counselling to ensure PIFU delivers sustainable capacity benefits in accordance with national standards.