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

At the moment, regular follow-up appointments are 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 patient initiated follow-ups work?

If your hospital care team think that patient initiated follow-ups might be suitable for you they will discuss this with you and you will be placed on a patient initiated follow-up 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 patient initiated follow-up 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 patient initiated follow-up 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 you experience any other symptoms, you should contact your GP or phone NHS 111 for advice.

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, please contact the number provided by your hospital care team and ask for a patient initiated follow-up appointment. Each team will have their own way of managing the booking process.

To arrange an appointment you must:

• Have been given a patient initiated follow-up plan and discussed this with your hospital care team
• Contact the service within the time-frame your hospital care team have discussed with you.
• Need an appointment for a specific health concern your PIFU plan relates to, rather than a new or unrelated concern.

Frequently asked questions (FAQs)

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

Because you are on a patient initiated follow-up plan, 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.

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 (telephone or video) consultation. Your hospital care team will talk to you about the most appropriate way for them to see you.

More information about video appointments is available via the link at the end of this page.

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 follow the "Outpatient digital letters and text reminders" link at the end of the page.

How do I provide feedback on my experience of patient initiated follow-up 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.

Further information

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