10. Avoid Unnecessary follow-ups

Do you know why you are offering each and every appointment?

Why are you seeing that family again next week, next month, in 6 months? What is that decision based on?

Are you the best person to see them again or could someone else such as the GP, school nurse, paediatrician?

Who would the family like to be reviewed by? What is most convenient for them?

Do the family really want and need to come next week?

What is the purpose of them coming to see you again? Is it because you haven't had time to think or discuss it and it was easier to make an appointment than not?

Which of your professional partners would be able to follow up families e.g. school nurses doing physical monitoring of those on methylphenidate?

This means being clear about why you are seeing them again


Avoiding unnecessary follow-ups and providing necessary ones in the right setting frees up a huge slice of capacity. Most ‘no shows’ in the NHS are for follow-ups. Many cases can be seen for fewer sessions if interventions are focussed and goal oriented. Many follow up appointments are ‘just in case’, due to clinician or family anxiety, or from lack of clarity of the care plan. Added bonus: planned follow-up in the right way by the right person adds quality for users and values their time as much as that of professionals. Choice is an integral part of this habit - ask users what they need.

Ideas for Action

  • Make you practice ‘no follow up unless a specific reason’. Follow up could be done by telephone, questionnaire, or referrer instead of you.
  • Ensure you set this up as rule from the start of contact.
  • Ensure this is agreed with referrers.

This item also helps you

Let Go of Families Implement High Impact Change number 5 Implement Our Choices in Mental Health