Unacceptable

As SandraF has said it's not that easy to get through on the phone to cancel an appointment. I made three attempts recently, each time holding for 10 mins without getting to receptionist. Finally I drove to the surgery and cancelled in person whilst pointing out the difficulty. The receptionist just shrugged. Many people wouldn't have bothered.

I just don't know the answer. But I do know that I was discriminated for years after (with massively long waiting times) when I missed a GP appointment, due to a road traffic accident (I wasn't in it, but held up by it) and couldn't phone due to lack of coverage. It felt unfair, particularly as once we realised that the road was impassable, we went home and phoned from there. But apparently phoning after the event doesn't count!

I’m on a Patient group at our local surgery and the majority of no shows are elderly people with dementia and people with mental health issues, (the practice knows who they are). They do write to each person after a no show and would eventually remove them from the practice list if repeat offenders not in a special category, but most are. Even I forgot a nurse appointment once,I was incredibly embarrassed. It happens. The Doctors do enjoy a few moments to catch up (they admitted) when it happens and it would be far too costly to run to charge people. The only realistic thing would be to charge a small fee for all appointments (as they do in Scandinavia) but I doubt this will go down well.

I’d love to know the truth for once, from someone who really knows instead of speculation or ‘someone told me. . . ‘

Are GP’s paid by appointments dealt with or by numbers of patients on the books?

I agree it’s unacceptable to ‘forget’ to attend, but all this hype about, ‘let’s fine DNAs’ would only provide jobs for someone to administer the process, costing the NHS even more, as someone has already said.
Would names of DNA listed on the wall/screen work?
It would give those who DO attend something to read while they wait for their 37 minutes overdue appointment. They could speculate over whether the Ms Jones or Mr Edwards are people they know and allow them an adrenaline rush of smugness that they did attend.
Our dentist, after 3 DNAs without giving 24 hours notice simply removes you from the practice register.

adaunas here you are. The article says that in the past GPs were paid for minor surgery that they did, but now they are not. They are paid a fixed sum per patient per year.
www.google.co.uk/amp/s/www.telegraph.co.uk/news/2017/01/27/no-146-per-patient-not-enough-time-gps-charge-fees/amp/

Several times we have had a letter to say that we had not kept an appointment only to discover that the actual appointment letter was "lost" somewhere.

I think it would cost more trying to collect fines i just can't understand why people don't turn up but some people really don't care

Well its strange then Suedonim. Obviously a worrier. But really the GP shortage is to blame for causing long waiting times. For all we know maybe lots of folk are doing the same and not cancelling because to be honest its a bit frightening when you know you will wait weeks for an appointment. Its really annoying that the government doesn't fix this. If you paid for a service elsewhere and didnt get it you would be entitled to a refund.

In the mental health unit I worked in in the UK we sent out appointment letters with a tear off slip at the bottom and an sae asking patients to return the slip confirming attendance or inability to attend. (didn't always work but we tried !) then we decided, if a patient had not attended a Consultant appt to call to see why ....sometimes (and this is true !) the patient would say 'oh I had a chance to go shopping/out for the day/etc'...were politely asked if, in future they cannot attend to please LET US KNOW ...if someone called within say, an hour of their appt, we would call someone who lived within fairly easy reach of the hospital and offer them the cancelled appt ......and yes, clinics were overbooked ....those returning for routine appts were then seen by an SHO instead of the Consultant, but it was very unusual for everyone to turn up ! DNA letters were sent referring them back to the GP and THEN they would ring up irate .......so we would explain to them, on the third occasion of a no show, you are referred back to the GP and have to ask them for a new referral ! I live in France now, and although I do not know what happens about no shows here (never not turned up myself !) we do pay 25 euros every doctor's visit and more for home visits, or a specialist consultation at the hospital ....but all cancer treatment and other long term illnesses are not charged for. Transport is provided if you are unable because of your illness, to get yourself to the hospital and from where I live it is in excess of 100km to the specialist hospital I need to go to . We also have to pay for a top up insurance (not private) and depending on what level we want to be covered, (I,e, hospitalisation for non ALD illnesses, specialist consultations, etc etc) it costs the two of us old people (!) more than 200 euros a month ....but for the services we get it is worth it ! Post Brexit if we are no longer covered by the reciprocal agreement, it would cost us around 2,000 euros a month EACH ...but then, if all elderly and ill people had to return to the UK can you imagine the cost to the NHS !! (unless it paid for Dignitas !) SO YES I think a charge would be an excellent idea ...perhaps leaving your credit card details with the GP surgery so a charge can be made unless the reason for the DNA is illness or death ! I cannot BELIEVE the NHS provdes interpreters as well, free of charge ! WHAT !!!!! here in France, as in Spain when we lived there, we were told if our language ability was not good enough we had to provde an interpreter and pay for it (which we happily did at 20 euros an hour !).......the NHS MUST do something or it will be impossible for it to continue to be a free #cradle to grave# service.

I think it's a bit of attention-seeking and insecurity, really, Annep. It's bizarre, really, because they're a born-again religious family and as a result of that, they 'don't believe in' lots of modern medicine! They think much illness is a case of mind over matter so the frequent medical visits don't tally with that at all.

I dont live in the UK but here where I live,we pay the equivelant of £12 to see our GP if you dont cancel the appointment, a little bill drops into your letter box so you still have to pay the same sum, believe me, not many peole just dont turn up, they may cancel but otherwise keep their appointments, we still have queues to wait for appointments!

There are always going to be exceptions to the rule, were for genuine reasons someone cannot cancel their GP appts as shown by the replies above. It is the people who don't seem to care less that cause the problems. They may no longer need the appt they booked, but its preventing someone else who needs an appt from seeing a doctor. It is really difficult in the area I live to actually get an appt in the first place, and we have had to link up with three other surgeries now as part of a group. No matter that our own surgery is within a reasonable walking distance,every appt we can get now is at one of the other surgery"s which seems to defeat the object of having a local GP when you are routinely sent to other ones much further away from where you live.

I would suggest that everyone should have to leave a deposit of about 20 pounds at the doctor's surgery per family member and, if an appointment is missed, then you would lose it and have to provide another deposit before getting another appointment. For a hospital appointment, it would have to be 30 pounds minimum. This would not even cover the lost costs, of course, so after every 3 missed appointments per person then the deposit could rise.
If some say that they cannot afford this then I suggest buying a couple less bottles of Prosecco or not having so many children and to make sure you never miss an appointment. This situation cannot be allowed to continue and citizens who choose to do the right thing will not be affected. When people die the deposit can be returned ( with any interest accrued) or donated to a charity of choice.

Where I live it is €4.20 to see the GP. I don't know if there are many no shows amd what happens about it as I belong to a private clinic as we could not get registered with a NHS doctor at the local health centre. An appointment with a doctor at the hospital costs €7.50 which you pay via a machine prior to your appointment. If there are any outstanding fees from before you have to pay these too before you get a number to see the doctor. Judging by how packed the waiting rooms are I woukd say most people turn up for their appointments. For accident and emergency you pay €12.50 on arrival then you are triaged as to how urgent it is and warned if it is not urgent at all you will have a wait in excess of 4 or more hours. At the end you then pay for xrays, blood tests or whatever other things you have had. This is in a country considerably poorer than the UK where the minimum wage is just being raised to €600 per month now.

At the GP practice I am with, a staff member told me 50% are not turning up for appointments. Dreadful.
It takes weeks to get an appointment, maybe people are making appts ahead, just in case.
Hospital appts here missed can mean you are chucked off the consultants list and have to ask GP for a new referral.

quizqueen, Would I be penalised for somebody else in my family missing their appointment? I have no problem leaving a deposit but if my adult son who lives at the same as address as me is careless with appointments, I don't expect to have to wait for him to pay £20 in again.

This thread assumes that the patient has been informed of the appointment

DD was receiving extended regular outpatient treatment at a hospital and never missed an appointment in two years, until the day she turned up for an appointment and was told her whole course of treatment had been cancelled because she hadn't appeared for an appointment the previous week, for which she had received no notification.

Thankfully she is assertive and persistent and they did final admit that a mistake had been made and reinstated her, but it took her consultant and the threat of a complaint to her MP to do it.

My husband needs regular COPD tests. He should have had one in September, but the nurse who made the appointment didn't communicate with reception, so when he attended, the appointment didn't exist. The test was rebooked for October, and when he attended he was told the wrong appointment had been booked, as he needed an extended appt, and not a standard one. Early in December, with some trepidation he attended his third appointment, only to be told it was too close to the nurses lunch hour. It was only because we stood in the crowded reception area and pointed to the huge sign saying how much time and money had been wasted through missed appointments that he was finally grudgingly seen by the nurse.

oldagetraveller and M0nica, if you have a chronic condition, you will realise how often this happens in the NHS. My daughter has a multi-systemic condition and we live on the healthcare boundary which causes regular problems like you have experienced.
One one of her appointments, we had to ring to see if they would have a bed she could lie down on whilst waiting as she could not sit for long periods and there is always a long wait coupled with the 2 hour drive to get to the hospital. You would have thought we'd asked for a miracle cure and it was only when I got involved that they finally managed a way forward. One of the things I always think is that hospitals are not designed for sick people.

icanhandthemback, there was the day they cancelled the surgeons operating session, but forgot to tell him or two of the patients on the list, one of the patients was DD. Fortunately she had an assertive surgeon who said 'I'm here, 2 patients are here. They will have their surgery' - and they did.

Then there are the dressing clinics who give a whole clinics full of patients the same appointment - 9.30 and some have to wait until 12.15 before they are seen.

I think the NHS has to pull it's own socks up before castigating it's patients

Yes, it's disgraceful.
In many countries - including some of those where the healthcare is supposed to be so much better - people have to pay - albeit maybe not much - for GP appointments.

A Swedish friend tells me that in Sweden everybody pays a small amount for GP and A&E visits, and for prescriptions and the 'hotel' element of hospital stays.
And this is in a relatively high tax country, popularly supposed to be a socialist Utopia.

Given the state the NHS is in, IMO its high time charges were introduced here, not just for the income, but to stop so many people abusing the service.

I don't suppose any govt. will ever have the guts, though - the 'free' NHS is such a sacred cow - there would be howls of outrage from here to eternity. The party of whatever colour would be terrified of losing votes, since whichever might propose it, the other would vow to vote it out. All any of the useless lot of them really care about is staying in power.

My brother in law lives in Norway and there you have to pay about £10 to visit a GP or the hospital. Seems a good idea to me, with the obvious exceptions of people who have to go often due to certain conditions and those unable to afford it.

There is no doubt that our wonderful NHS needs funds and a small charge isn't too much to ask from the majority. It would help people to realise the importance of the doctor's services.

It could be that the people missing appointments have forgotten, as they booked 5 weeks ago.

I do agree that NHS admin needs a good shake-up. Dh was recently sent to the wrong centre for a minor procedure, so it was impossible for him to make it in time to the right one. For all I know that could be down as a 'missed appointment' though it was not at all his fault.

My BiL was recently sent a hospital appt. letter to an address where he hadn't lived for 17 years - this despite several such letters having been sent to the correct address in the meantime. If it hadn't been for the current resident forwarding it in time, he'd have missed that appt.

Also I've heard of umpteen cases of appt. letters being sent to people with dementia, despite relatives pointing out time and again that even if they don't just throw the letter out or hide it, the person will never remember.

How many missed appts. such cases must amount to, I wouldn't like to guess.
'patient confidentiality' is always the reason given - often they won't send a duplicate to the relative who can make sure they attend.

Of course redirecting the post could be the answer, but this may not be possible unless the person has been officially deemed to lack capacity, which may never actually happen, or at least not until after hospital appt. problems have arisen.

My dentist has a list of missed appointments. These come to an average of 350+ a month. Because many people pay for dental treatment this must have a financial impact on the practice.

However, I don't see how a patient missing a doctor/hospital appointment costs money. I thought this had actually been pointed out by a consultant.

It is, of course, very rude to miss an appointment which could have been offered to someone else as waiting lists are often very long.

Last year I had two appointment letters for different Hospitals but for the same time & day . Now with the best will in the world I can't split myself in two, one appointment was for a scan the other for the Consultant who needed the scan results before the Consultation., which only goes to prove departments don't "talk to each other". I rang the Hospital, lady saw the funny side & changed my appointment with the Consultant a month later luckily it wasn't critical