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Patient-initiated follow-up (PIFU)

This page explains what patient-initiated follow-up is, how it works, and how to arrange an appointment if you feel you need one.

What is patient-initiated follow-up (PIFU)?

Patient-initiated follow-up is a more flexible approach to follow-up hospital care.

If you decide to use PIFU, you contact us to book follow-up appointments when you feel you need them, instead of having follow-up appointments at set intervals.

This means if your condition is stable and you don’t have concerns, you don’t need to have a follow-up appointment. But, if you do need support, you can contact us to arrange an appointment quickly and easily.

Who is PIFU for?

PIFU is most often used by patients with long-term (chronic) or stable conditions who do not need frequent appointments but may need occasional support.

This includes:

  • patients with long-term conditions, such as arthritis, asthma, or diabetes
  • patients recovering from surgery or treatment
  • patients with symptoms that change over time but don’t need constant monitoring

If PIFU may be suitable for you, your clinician will discuss it with you at your appointment. They will explain how PIFU works and answer any questions you may have.

Do all outpatient clinics offer PIFU?

Most specialties will offer PIFU. However, for some specialties, PIFU isn’t suitable. This may be because patients will need regular reviews, or patients can be discharged straight away with no follow-up. Please ask your clinician if you need information.

What are the benefits of PIFU?

  • More flexibility – spend less time attending hospital appointments, but still have access to support from a hospital specialist when you need it
  • More control – decide when you need an appointment and treatment from your hospital department
  • More convenient – reduce the amount of time you need to take off work or school to travel to appointments
  • Quicker – if you need help, you’ll be seen sooner than waiting for a routine, scheduled appointment

How does it work?

  1. Your clinician will add you to a PIFU pathway – if PIFU is suitable for you, we’ll discuss your condition with you and explain the signs or symptoms that mean you need to make a PIFU appointment, and how long PIFU will be available to you for.
  2. If you need help, book a follow-up appointment – contact us using the phone number or email address we give you and ask for a patient-initiated follow-up appointment
  3. Attend your appointment – depending on your needs this will be by phone, by video, or face-to-face

How long does a PIFU pathway last for?

Your clinician will tell you how long you will be on a PIFU pathway. For example, 3, 6, or 12 months, or longer.

At the end of your PIFU pathway, you will be discharged from the hospital back to your GP, unless you’ve had a PIFU appointment that’s shown you need to stay under the care of the hospital for longer.

How long will I have to wait before I get an appointment?

If you get in touch because you have the signs or symptoms that mean you need to make a PIFU appointment, a clinician will review your symptoms with you and decide the most appropriate next steps, including how quickly you need to be seen. We may give you advice or support over the phone, or you may need to come in for a face-to-face appointment.

Do I have to agree to a PIFU pathway if it’s offered to me?

No, you do not have to agree to a PIFU pathway if you do not feel it is right for you. If you and your clinician decide regular scheduled appointments are better for you, we’ll continue with scheduled follow-ups until you are able to be discharged from our care.

What if I need urgent help?

  • If you need urgent medical help, contact your GP, NHS 111, or visit an urgent treatment centre
  • In an emergency, go to your local Emergency Department (A and E)

Will I lose access to care if I am on PIFU?

No. You will have access to the care you need when you need it.

What if my symptoms return after my PIFU pathway has finished?

If your symptoms return after your PIFU pathway has finished, speak to your GP. They will refer you as needed.

Where can I get further information?

  • The healthcare team that offer you PIFU will be happy to answer your questions. Their contact details will be on the letters they send you.
  • You can find your appointment letters on MyChart, our patient app and website. MyChart is a convenient and secure way to access and update your health records and appointment information.