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During your outpatient appointment, you and your healthcare professional will have a conversation about the available treatment options, to help you decide what would suit you best.

Some patients will be offered a 'Patient Initiated Follow Up' (PIFU) appointment. This type of appointment allows you to arrange a follow-up for yourself as and when you need it.

You can arrange an appointment for yourself based on your individual symptoms, and receive guidance when you need it. This is an alternative to a routine follow-up appointment which can be a source of stress and expense, and which you may not always find helpful unless you have a specific concern you wish to discuss with your healthcare professional.

How does it work?

If PIFU is suitable for you, your healthcare professional will discuss your condition with you and add your name to the PIFU appointment list. Instead of being given routine follow-up clinic appointments, you will be able to contact the service directly to arrange a follow-up appointment if you feel you need it. 

Your healthcare professional will then advise on the symptoms you need to watch out for and provide you with a guide card to help you decide whether you need to make an appointment because your symptoms have returned or got worse. If you experience any problems with your condition, or complications after treatment, please use the information on the guide card to contact the service to arrange a PIFU appointment. 

You will also be told how long you will stay on the PIFU waiting list as determined by your clinical condition. If you do not need to see the doctor or nurse about your condition within the specified period after your last appointment, you will be discharged back to your GP who will re-refer you if you need to be seen again in the future.
Graphic with the words PIFU: Patient initiated follow up. Diagram showing the first two stages- consultation and decision making- and the two branching next stages- discharge to PIFU, and move to PIFU.


Between patient and clinician, face-to-face or virtual

Decision making

Shared decision made to use PIFU.

Info given to patient on how and when to use service

Discharge to PIFU


Move to PIFU

-> Clinician sets a time period, after which patient is automatically discharged.

Patient can request PIFU appointment before that date if needed.

-> Regular appointments scheduled. Patient can request PIFU appointment in-between if needed.

Why are we introducing this new type of follow up?

We are implementing this type of follow up because it offers a number of benefits:

  • PIFU puts you in control of your own outpatient follow up. Appointments can be made based on your individual needs instead of being at routine intervals, which often do not add value for patients and waste valuable resource. If you experience a flare-up in symptoms, you will be able to receive guidance when you need it.
  • Patients frequently spend time and money to attend appointments that are not essential. The number of people making these journeys will be greatly reduced and we hope it will improve your experience.
  • Freeing up appointments means we can reduce the waiting times for people who need an appointment, enabling them to be seen more quickly.
  • It will also help us to cut down our carbon footprint by reducing the number of unnecessary journeys made to our hospitals