Duration: 01 December 2025 - 30 November 2026
Funder: NHS Grampian Endowment Fund
Chief investigators: Professor Gareth Jones
Co-investigators: Professor Gary Macfarlane, Dr Rosemary Hollick, Dr Lindsay Robertson (NHS Grampian)
Over the past few years – and particularly since the COVID-19 pandemic – the management of patients with a number of rheumatological conditions has moved away from routine follow-up visits (e.g., annual appointments) and towards a patient-initiated follow-up (PIFU) approach. Under PIFU, if a patient feels they are managing well, they do not need to attend an appointment. But if they feel they need some advice or assistance, or a change in treatment, they can call up and initiate their own appointment. Not only is this more efficient for the NHS (by reducing unnecessary follow-up visits among patients who feel they are managing well), but it enables patients to have more control over when they receive care and makes the best use of clinical time.
However, it is not without its concerns. While many patients may be well, and perfectly happy, others may feel ‘out of sight, out of mind’, and be reticent to phone for an appointment, even if they feel their health has deteriorated.
This project aims to evaluate the PIFU service in Rheumatology in NHS Grampian and to compare patients who have, versus have not, accessed care while on PIFU. Using surveys and analysis of health data that is routinely collected, we will determine whether there are differences in various health outcomes between patient groups and examine whether there are differences between different patient groups. We will interview patients and health professionals in Rheumatology, and in primary care, to explore their experiences, and how they feel about the new approach to patient management. Finally, we plan to hold a consensus workshop to share findings, distil learning about key factors that enable or inhibit effective implementation of PIFU, and frame guidance for local, regional and national rheumatology service planning.