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).

What are ‘Patient Initiated Follow-Ups’?

Traditionally, follow-up appointments are scheduled by the hospital at regular intervals, such as every six months or annually. While some patients find these regular visits helpful, others may find them unnecessary or stressful. With a PIFU plan, you can schedule follow-up appointments with your hospital care team when you feel it’s necessary, such as if your symptoms worsen. This approach gives you more control over your follow-up care and ensures you receive support when you need it most.

Why ‘use PIFUs?

PIFUs offer several benefits:

  • Control: You decide when to request follow-up appointments based on your needs.
  • Personalisation: Appointments are tailored to your individual health requirements.
  • Convenience: Reduced hospital visits mean less time off work and less travel.
  • Efficiency: Fewer unnecessary appointments free up slots for patients who need them.
  • Sustainability: Reducing unnecessary travel helps lower our carbon footprint.

How do PIFUs work?

If your hospital care team believes a PIFU plan is suitable for you, they will discuss it with you and place you on the plan. You will no longer receive regular follow-up appointments; instead, you will contact the hospital when you need an appointment. Your specialist will inform you how long your PIFU plan will last. If you don’t need to see your specialist during this period, you may be discharged back to your GP, who can refer you again if necessary.

Some patients with long-term conditions may not be discharged from the hospital. Your specialist will explain what will happen at the end of your PIFU plan. If you are under the care of multiple departments, remember that your PIFU plan may not apply to all of them. Some departments may still schedule regular follow-ups, which you should attend to monitor your condition.

What do I need to do?

  • If you are placed on a PIFU plan, your specialist 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 you or your carer should:
    • Contact the department and say that you are on PIFU or Patient Initiated Follow-Up
    • Submit a request for an appointment via the My Care Patient Portal App or via following the weblink in your PIFU welcome SMS message.
    • You can also call the booking team on 0208 725 0007and say you have a PIFU

They will ask you to:

  • describe your symptoms
  • remind us of any special requirements that we need to take into account

The specialist team will then organise your appointment and get back in touch with you to arrange a phone or face to face appointment.

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.

If your situation changes and you no longer need your appointment, or you need to change your appointment date, phone and tell us straight away. We will then be able to offer your appointment slot to someone else who needs it.

When not to use PIFU

PIFU is not a replacement for urgent medical advice. For urgent concerns, contact your GP, NHS 111, or your local walk-in centre.

In emergencies, go to your local Emergency Department (A&E).

Can I contact the PIFU service for new conditions/problems?

No, the PIFU Pathway should only be used for the conditions agreed with your clinician. For all other concerns or if you are feeling unwell, please contact your GP.

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.

An appointment, if required, will be offered at the next available date as this service is not for urgent or emergency care.

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, your specialist will review your request and offered an appointment based on the clinical urgency. 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 request 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’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 specialist team in the first instance. They will value your feedback.

You can also contact Patient Advice and Liaison Service (PALS} for on-the-spot advice and information when you have comments or concerns about our services or the care you have received. You can visit the PALS office between 9.30am and 4.30pm, Monday to Friday in the main corridor between Grosvenor and Lanesborough wings (near the lift foyer). Tel: 020 8725 2453   Email: pals@stgeorges.nhs.uk

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.