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Patient-initiated follow-up (PIFU) appointments

In some of our clinics we are offering a different way of arranging outpatient appointments called patient initiated follow-ups (PIFUs).

Regular follow-up appointments are usually arranged by the hospital at set intervals, for example, every six months or every year. Some patients find these regular visits useful and reassuring. For others, it can be frustrating or stressful coming to hospital if they don’t feel they need to.

Through your patient initiated follow-up plan you can arrange follow-up appointments with your hospital care team when you feel you need them, or if your symptoms get worse. This puts you in control of your follow-up appointments and gives you access to support and guidance when you need it most.

How do PIFUs work?

If your hospital care team think that PIFUs might be suitable for you they will discuss this with you and you will be placed on a PIFU plan. This means you may not receive regular follow-up appointments anymore and you will need to contact the hospital if you feel you need one.

Your hospital care team will tell you how long your plan will last for and you will be on a dedicated PIFU plan list which will be checked regularly. For some patients, the PIFU plan might be open-ended. In most cases, if you don't need to see your hospital care team at all within this time period you will be discharged back to your GP, who will refer you back to the hospital if you need to be seen again in the future.

There will be some exceptions to this for patients with certain long term conditions where it may not be appropriate for them to be discharged from the hospital. Your hospital care team will discuss this with you and make you aware of what will happen at the end of your PIFU plan. If you are under the care of more than one department, it is important to remember that your patient initiated follow-up plan doesn’t apply to all of them.

Some departments may still send you regular follow-up appointments and it’s important that you attend these so that they are able to monitor your condition.

What do I need to do?

If you are placed on a PIFU plan, your hospital care team will discuss which symptoms you should look out for and give you this information in a written format so you can refer back to it. If you experience any of these symptoms, please contact the service as soon as possible to arrange an appointment.

The service will provide you with the relevant contact details.

If your condition worsens or causes concern while you are waiting to be seen by the hospital specialist, please contact your GP who can request advice from one of our clinicians if necessary.

If you feel that you are seriously unwell, please call 111 or, in an emergency, call 999. 

Visit the NHS website for advice on helping you take control of your health and wellbeing.

What are the benefits?

This type of follow-up offers a number of benefits:

  • You have more control over your follow-up appointments and when you have them
  • Appointments are made based on your individual needs
  • For many people it will mean they don’t need to come to hospital as often, meaning less time off work and travelling
  • With fewer patients coming in when they don’t need to, we can make appointments available more quickly for those that do need them
  • We can also reduce our carbon footprint by lowering the number of patients travelling to the hospital unnecessarily

How do I book an appointment?

To book an appointment, you can either contact the number provided by your hospital care team and ask for a PIFU appointment, or you can submit a digital request via the DrDoctor patient portal. If you follow the web link in your PIFU welcome message, you will see a page providing more detail about any specific symptoms you should look out for  which indicate you need an appointment.

Once you have read this guidance and if you choose to continue, you can submit a digital request for an appointment by selecting the ‘Start’ button. You will be prompted to identify yourself using your name, date of birth and postcode.

You can then provide details about why you are making the request and whether you would prefer a telephone, video or face-to-face clinic appointment.

I am still waiting for an appointment after making a request?

At the time you requested your PIFU appointment, you will have been provided with an estimated response time, usually between three and 14 days. This is to allow the administrator time to speak to your clinician and agree the most appropriate action to deal with your request. This could result in advice given to you and/or your general practitioner (GP), or an outpatient consultation delivered either by telephone, video or face-to-face in one of our clinics.

Your DrDoctor patient portal will indicate the stage that the request is currently at, such as ‘Request Pending’which means your request is being reviewed to decide the best solution for your specific issue raised. An appointment, if required, will be offered at the next available date as this service is not for urgent or emergency care.

If your condition worsens or causes concern while you are waiting to be seen by the hospital specialist, please contact your GP who can request advice from one of our clinicians if necessary. If you feel that you are seriously unwell, please call 111 or, in an emergency, call 999. 

How long will I have to wait for an appointment if I need one?

If you need to be seen because your symptoms have worsened, you will be given priority and offered an appointment within the timescales agreed with your hospital care team. This is usually at the next available date as this service is not for urgent or emergency care.

However, if your condition worsens or causes concern while you are waiting to be seen by the hospital specialist, please contact your GP who can request advice from one of our clinicians if necessary.

If you feel that you are seriously unwell, please call 111 or, in an emergency, call 999.

Why have you set a deadline for me to make an appointment?

Your plan will last for a specific amount of time. Your hospital care team will talk to you about how long you may need to keep your plan open depending on your condition and their clinical judgement of how long you may need before you can be discharged back to your GP, if this is appropriate.

Will my PIFU appointments be face-to-face consultations at the hospital?

If you need to arrange an appointment, this may be a face-to-face or a virtual (video or telephone) consultation. Your hospital care team will talk to you about the most appropriate way for them to see you.

Please visit the online video consultations page for more information on virtual appointments.

I use DrDoctor to manage my outpatient appointments and view my hospital letters. If I am on a PIFU plan, will I still be able to use DrDoctor?

Yes, you can. If you don’t use DrDoctor at the moment but want to find out more, please see the digital letters and text reminders page.

I’ve tried to request an appointment but it states I am not eligible, why?

Your PIFU care plan will last for a specific amount of time. Your hospital care team will talk to you about how long we may need to keep your PIFU care plan open. This will depend on your condition and their clinical judgement about how long you may need on the plan before you can be discharged back to your GP. This message indicates that your PIFU period has now ended; please contact your GP who can request advice from one of our clinicians if necessary.

How do I provide feedback on my experience of the PIFU plan?

Please contact your hospital care team in the first instance. They will value your feedback.

As part of the Trust’s ongoing commitment to better understanding the experience of its patients, the Patient Experience team may contact you for feedback following your appointment or visit. You may be asked for feedback via text message, telephone, email or letter.

Where can I find more information on PIFUs?

If you have any questions, please speak to your hospital care team for advice. They will have provided you with the relevant contact details.

You can find a useful video below, which was created by Humber and North Yorkshire Health and Care Partnership. This explains how PIFU works and its benefits.

Last reviewed: 20 July 2023