What is PIFU?

Information for Patients & Carers, who are added to a Patient Initiated Follow Up (PIFU) Pathway by their clinician as part of their outpatient follow-up management.

Following your appointment with the doctor or specialist clinician, you may be placed on a Patient Initiated Follow Up (PIFU) Pathway. PIFU is a new model of outpatient clinic management which puts you in control of making an appointment with your healthcare team or seeking advice when you need it the most rather than attending appointments when you are not having a problem.

Many people find that routine follow up visits to the hospital cause unnecessary stress and anxiety, because they need to travel and miss work, school, or other commitments. On the other hand, worsening of your symptoms can happen anytime and you should be able to see your healthcare team sooner if this happens. You may or may not be offered a future appointment (depending on your condition), however you will be advised on whom to contact if you do need an appointment.
You can make an appointment to see your healthcare team by requesting an appointment, if you have any concerns related to your condition or symptom. This stops you from attending frequent review appointments when you do not want or need them. Instead, you can contact us, and we will arrange for an appointment to be made when you need one. This appointment can be face to face at the hospital, on the telephone or through video.

How does it work?

During your clinic appointment, you will be advised by your clinician if your condition is suitable to have your follow-up appointments as ‘patient-initiated’ instead of regular appointments. If you have a long-term condition, you may still be offered a future appointment as part of your annual review or monitoring plan. 
Your clinician will discuss the process with you and your suitability and provide you with relevant patient information to consider your options. It is your decision if you would like your appointments to be managed this way.

You will also receive your clinic letter as normal as well as additional patient information, on what symptoms to look out for and how to contact the service should you require an appointment if you have any concerns or symptoms related to your condition and would like to speak or see a clinician.

When should I not use PIFU?

If you require urgent medical advice, you should contact your GP or NHS 111, or if you are really unwell, your local Emergency Department (A&E). For all other concerns not related to your PIFU condition, or if you are feeling unwell, your GP remains your first point

Types of PIFU appointments

Depending on your condition, there are two main PIFU pathways where you may be placed:

  1. PIFU Open Pathway
    Your clinician will discuss with you, the option of not booking a future appointment and instead, having an open appointment which you will be able to request for a certain period of time. This time-period will be agreed with you based on your condition and what is clinically safe for you. If you do not contact the hospital during this period, you may be discharged back to the care of your GP.
  2. PIFU Booked Pathway
    In this pathway, the clinician would still book an appointment for you (especially if you have a long-term condition). If you do not require an appointment before this booked appointment date, you will still be required to attend this booked appointment as normal. In both cases, your clinician will share with you, patient information on what symptoms to look out for and whom to contact, should you have the need for an appointment or advice.

How do I book a PIFU appointment?

Your clinician would advise you on whom to contact should you require a PIFU appointment. This will also be detailed in the clinic letter, that you and your GP should receive after you have attended your clinic appointment.

Contact details for booking a PIFU appointment

Will I still be under your care if I do not call for a PIFU appoinment?

This will depend on the type of PIFU pathway you have been placed on by your clinician.
If you have a future appointment booked as part of the PIFU pathway, you will still be under the care of your clinician.
If you have an open appointment, you will be under the care of your clinician for the duration of the PIFU time-period agreed with your clinician. If you do not contact us within this time, you may be discharged back to the care of your GP and your GP take over your care.

When should I contact the hospital for a PIFU appointment?

If you have a future booked appointment, then you can call anytime before your appointment to speak to a clinician or request an appointment.
If you have been offered an open appointment, then you will need to call within the time-period that has been agreed between and your clinician. This will be detailed in your clinic letter and can vary from anytime between 2 months to 24 months. You will need to be aware that you may be discharged back to the care of your GP if you do not have a need to contact us during this period.

What if I am worried and change my mind about this style of follow up?

Some patients express concern about losing regular contact with the hospital. Everyone had different feeling when they no longer need to be seen regularly by their healthcare team. If you wish to go back to booking regular hospital appointment, just tell us and we will arrange this for you.