Established practice
Unnecessary follow-up appointments fill the diary and block new patients
A large share of outpatient follow-ups in private practice could be safely managed remotely. But without a system to do it, consultants default to face-to-face. That blocks capacity and frustrates patients who don't need to come in.
- steps
- 7
- steps
- to start
- 5 seconds per appointment for 4 weeks
- to start
The short answer
Many routine follow-ups are booked by habit rather than need. Audit a month of them, write down which conditions genuinely need a face-to-face review, and use patient-initiated follow-up, telephone or video reviews, results letters or discharge for the rest. Use the freed slots for new patients and tell referrers your wait has come down.
7 steps
Do it yourself: step by step
0 of 7 done
For 4 weeks, note after each follow-up whether it changed management and whether it could have been done by phone, letter or not at all.
- Time
- 5 seconds per appointment for 4 weeks
- Typical cost
- Free
- Who does it
- You
Done when: Audit of every follow-up for a month
This problem is Solvable.
Copy this template
Follow-up decision rules and patient-initiated follow-up letter
Free to copy, adapt and use. No sign-up.
Follow-up decision rules
| Condition or procedure | Face-to-face | Remote (phone or video) | Patient-initiated | Discharge with advice | Notes |
|---|---|---|---|---|---|
| [Condition 1] | [when] | [when] | [window] | [when] | |
| [Condition 2] | |||||
| [Procedure, routine recovery] | |||||
| Normal results | Letter or call |
Use your clinical judgement for each patient; these are defaults, not rules that override it.
Patient-initiated follow-up letter
Dear [Patient first name],
Following your appointment on [date], we have agreed that you do not need a routine follow-up appointment. Instead, you can contact us directly if you need to be seen.
Please contact us if: [symptom 1], [symptom 2], [symptom 3].
If you experience [red flag symptoms], seek urgent medical help through your GP, NHS 111 or A&E.
How to contact us: [secretary name], [phone], [email], [hours]. We will arrange an appointment within [X] working days.
This arrangement lasts until [date]. After that, you will be discharged, and your GP can refer you again if needed.
A copy of this letter has been sent to your GP.
With best wishes, [Mr/Ms/Dr Name] Consultant [Specialty]
Avoid these
Common mistakes
- Booking a follow-up by default at the end of every consultation.
- Using clinic slots to give normal results.
- Moving patients to patient-initiated follow-up without clear written red flags.
- Not checking how insurers pay for remote follow-ups before switching.
- Freeing slots but never telling referrers your new patient wait has fallen.
Free personal check
Done by Paul Robinson, not software
I'll check your follow-up ratio and show what freeing some slots could be worth
What I need from you
- New patients a month
- Follow-ups a month
- Your new patient fee and follow-up fee
What you get
- How your follow-up ratio compares with what I usually see
- What refilling freed slots could be worth
- Where to start safely
Within 2 working days
No sign-in, no sales call. I read every request myself and reply on WhatsApp.
Free tools
Check where you stand
Benchmarks
20% to 40% of routine follow-ups could be managed remotely, by letter or by patient-initiated follow-up
Solvable estimate, not a published figure: varies widely by specialty, higher in stable chronic monitoring, lower after major surgery. Your own one-month audit in step 1 replaces it
Solvable estimate
Paul Robinson
14 years in UK private healthcare
I solve this one for consultants
Want a hand? I'll look at your situation and tell you the three things I'd tackle first.
A few quick questions, about two minutes. I read every one myself and usually reply the same day.
No sales call unless you ask for one. Just a straight answer from me.
I reply personally, usually the same day.
Questions
Frequently asked questions
Is patient-initiated follow-up safe?
For the right patients, with clear written advice and a reliable way to get back in, it is widely used; NHS England publishes guidance on it. Review outcomes after 3 months.
Will I lose income?
You lose some follow-up fees but gain higher-value new patients, and new patients lead to further work. Model it with your own fees.
Do insurers pay for telephone or video follow-ups?
Many do, but the rules and fees vary. Bupa, for example, has separate terms for remote consultations, which replace rather than add to an in-person consultation. Confirm with each insurer.
What about patients who want to be seen?
Offer it. The aim is to stop routine appointments by habit, not to refuse patients who need or want them.
How do I tell the GP?
Copy them into the patient-initiated follow-up letter, so they know the arrangement and the end date.
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