Alcohol Liaison Nurse, Anthony Gartland smiling at the camera

Our new appointment types

We want to give you the best care and experience possible and we recognise that attending hospital for an outpatient appointment is not always the right option for you.

It may mean that you have to take time off work, or get somebody to come to the hospital with you. We also know that car parking can be difficult and that all of these things can add to your worries.

As such, we have decided to change how we manage our outpatient services and it may be possible for you to have a different type of outpatient appointment such as a telephone or video call, or a results letter.  

Each one of these appointment types is explained below to help you decide what the best option is for you.

Please remember though that your safety and ensuring that you get the best treatment and outcomes are our top priority, so we will only offer a non-face-to-face appointment if it is appropriate to do so.

Telephone appointment

You will be given an appointment slot in the same way that you would for a face-to-face appointment, but instead of attending one of our locations, your doctor or nurse will contact you by telephone to discuss how you are feeling or your results.

Video appointment

You will be given an appointment slot in the same way that you would for a face-to-face appointment, but your doctor or nurse will video call you to discuss how you are feeling.

One-stop clinics

In a one-stop clinic you will see your doctor or nurse, who you may send you for a test such as a CT scan or ultrasound during your appointment.

Your results will be reviewed by the clinician after a short wait and they will then discuss the results and next steps in your care with you.

These appointments often take longer and you may need to be prepared to be at the hospital site for most of the day however, the benefit is that you are not waiting for a long time to get the results of your tests or to understand what is going to happen to you next. This type of clinic helps you and our doctors quickly plan any treatment that you may require.

Straight-to-diagnostic tests

Your doctor may read your referral letter and decide that you need to have diagnostic tests before an outpatient appointment. They will refer you for any necessary tests and once these have taken place, you will be sent an appointment to discuss your results.  Having your tests before you see the doctor or nurse helps the clinical team to have a more informed discussion with you at your first appointment.

Group clinics

You may be offered the opportunity to attend a group clinic. These provide a good opportunity for meeting people who have the same condition or illness as you and for when the clinical team want to provide some teaching about how best to manage your condition.  These types of clinics are often run by other types of health professionals such as physiotherapists or dieticians.

PIFU Appointments

Patient Initiated Follow Up Appointments (PIFU)

During your outpatient appointment, your healthcare professional will advise you on the next steps of your treatment.

Some patients may be offered a 'patient initiated follow up' appointment (PIFU for short). This type of appointment allows you to arrange a follow-up for yourself as and when you need it.

Research has shown that having a regular outpatient follow up does not help to prevent your condition returning or identify new problems. In fact, many people find that follow up visits to the hospital cause a lot of unnecessary anxiety.

Patient initiated follow up appointments can help reduce unnecessary visits to hospital, reduce patient waiting times and release clinical teams to see more patients in a timely manner.

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.

The majority of patients with long-term conditions, or following a hospital treatment, do not require regular follow up by the hospital team.

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 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.

How do I book a follow-up appointment?

To book an appointment, call the number provided by your clinician and ask for a “patient initiated follow-up appointment”. If you have been given an email address, rather than a telephone number, please email us to request an appointment.

Please note, to arrange a patient initiated follow-up appointment you must: 

  • Have been told by your healthcare professional that this is appropriate for you
  • Have a guide card, provided by your health professional, explaining how and when to contact the service to arrange an appointment
  • Contact us within the timeframe advised by your clinician


Advice and guidance

There are different types of advice that we can offer depending on the nature of your condition. Some of our services offer helplines that you can call to speak to a nurse or a pharmacist. One example is the Inflammatory bowel disease (IBD) helpline run by our clinical nurse specialist team in Gastroenterology.

We also offer this option to our GP colleagues. Your GP may contact your hospital doctor to request some advice about your medication or a change in symptoms that you have experienced. Your hospital doctor will either telephone or write back to your GP with some information about how to manage your condition.

Virtual clinical review

There are three different types of virtual clinical review: 

  1. Your doctor or nurse may have seen you in clinic for an outpatient appointment and then referred you for diagnostic tests. If the results of the tests are within normal limits or if your clinician decides that it would be better for you to be monitored by your GP and not by a hospital doctor or nurse, then a letter is written back to your GP advising them on the plans for your care. 
  2. Your doctor may review the referral letter and send you straight for diagnostic tests before you have an outpatient appointment. If your tests are within normal limits or if your clinician decides that it would be better for you to be monitored by your GP and not by a hospital doctor or nurse, a letter is written back to your GP advising them on the plans for your care. This is called a “fully managed virtual pathway”.
  3. You may need to have regular surveillance tests such as endoscopy or scans every few years. If there is no change or only a minor change in your condition after your doctor has reviewed your results, a letter may be written back to your GP advising them of the results of your tests. If there have been changes to your condition, you may be offered an outpatient appointment to discuss the results.

If your doctor or nurse decides that the best option for your care is to manage your referral via one of these virtual review options, please remember that all of your clinical information and results will be reviewed by the most appropriate clinical expert making sure that you receive the same high standards of care as you would in a more traditional appointment type.

How you can get involved

If you are keen to have a consultation that is conducted in a non-face-to-face way, such as on the telephone by video, please let your doctor or nurse know.  Please remember though, that some conditions and illnesses may require a physical examination and so an alternative appointment may not be an option. However, it is important that we understand what you would like and what would suit your lifestyle so that we can ensure that we offer this to you wherever possible and appropriate to do so.

Royal Surrey Charity