Unacceptable

I don't know what the answer is but a simpler system might help. For instance, my Dh was sent a routine hospital appointment at very short notice. If we'd happened to be away on holiday, he'd have been completely unaware of the appt but would have been down as a No Show, which would be unfair.

Some people seem to have no problem getting appointments, though. I know someone who must see the doctor just about every week. She made an appointment for the week before Christmas just in case she felt ill and needed to see the doctor! I've decided that if there's a three-week wait if I need to see a doctor, I'll get this friend to make the appointment for me.

I recently arrived for an appointment, signed in with the electronic arrival board and took my place in the waiting room. Fortunately I checked my phone while I was waiting and found my appointment had been cancelled as the doctor was off sick! I can't see texts at work as my phone has to be kept in my locker and I was in a rush to leave to make the appointment on time so didn't check if I had any messages. Pity they couldn't connect the cancelled appointments to the arrival board information. I was pretty annoyed as I then had to make a new appointment and wait another 2 weeks as well as having wasted time going for the original appointment. The fact is the systems are not perfect but everyone tries their best. Overbooking to allow for missed appointments is one solution but I don't think charging is realistic as it would add even more administration. I once missed an appointment myself and was mortified when I realised. I phoned to apologise and re-book and they were very understanding - can't remember now how it happened.
It seems that benefit claimants are effectively fined for missed appointments by having their benefits withheld but this causes untold hardship when there are often valid reasons for the missed appointment.
However maybe some sanctions need to be in place for regular repeat offenders. I'm sure surgeries know who they are.

GPs certainly use the time of DNAs to catch up, the time is not wasted, they are vastly overstretched. Of course I would encourage anyone to cancel their appointment, but if the only way you can do this is by phone, then so often you can't get through. There does need to be a huge push for people to be able to do this online, the technology is there, but surgeries haven't got the time and resources to implement it and train staff.

Hospital appointments are totally different, some hospitals struggling with workload have a policy of ringing elderly, vulnerable patients and giving them an appointment the following day. They may be carers, they may have transport problems, they may have a dog that can't be left all day, all sorts of reasons why they need more notice. By doing this and knowing patients would be unable to accept them at such short notice they are put to the back of the queue again, and the hospital escapes a fine for backlog. I have sat in meetings where this policy is promoted!

Fining patients is not the answer, as others have said, it would cost more in administration and legal fees that ever would be recouped in fines. Make it easier to cancel, and you might reduce some of the DNAs.

I think it's the height of bad manners not to turn up for any appointment unless previously cancelled by phone.

Whilst I totally agree with the utter waste caused by missed appointments, it might be simplistic to say that the person not making the appointment should ring in to cancel. At my practice you can spend an hour trying to get through with the phone perpetually engaged. Not everyone has a mobile phone to send and receive texts from the practice.

Totally agree with this, unless the person has a very good reason for missing it. I had to miss an appointment (well cancelled an hour before) as my husband collapsed and had to be admitted to hospital! Unfortunately not same place as my appointment. However, like goldengirl, I to have also missed a hospital appointment as the letter arrived the day after the appointment. Perhaps this type of “missed” appointment is part of the reason why I waited OVER a year for one appointment.

I agree but I got ticked off for not attending a hospital appointment when I didn't know I had one! I received the letter AFTER the appointment date!!! Needless to say I followed it up with a letter of my own copied to my GP.

Petra Our receptionist told me our system couldnt do it. I'm in N Ireland. maybe ours is different.

First I must say that for all the reasons already aired I couldn't agree more that precious medical appointments should not be wasted.
However, there are people who fall by the wayside because they don't fall in to the category of 'fully able to take care of themselves' or 'needing full time care'. I suppose I am mainly talking about those with both physical and mental health problems. A GP can may refer a patient to a consultant but the patient then has to engage with the service provided. Not everyone has a family or friend to rally round and ensure they take care of themselves, in this case by attending an appointment.
I don't know what the answer is, and it certainly does not apply to all missed appointments, but it again highlights a shortfall mental health care.

I totally agree that people should be fined for not turning up to the appointments. How rude not to cancel their appointment and let others be able to see the doctor.

annep
Millions do get text messages. It's not a new thing, it's been operating for some years.

I wonder how it works in other countries.

I would have thought that if we had to pay for missed appointments, the number would reduce considerably. I realise it's not that simple though.

Our hospital sends appointments out and, as Nonnie stated, if you can't attend you are put to the bottom of the list. There must be another way of organising the system eg why can't you just be swapped for the person next on the list if you can't attend? It also amazes me how the clinics can be running late first thing in the morning or afternoon with car park charges being incurred. I recently attended a 14:30 appointment and had to be there fifteen minutes before for tests. The tests and appointment with Consultant took less than tweny minutes in total. I left the hospital at 17:00 hrs because the clinic was over running. However, I did notice a prisoner being taken straight through when he arrived and he was out and gone in less than thirty minutes, I did wonder if he jumped the queue.

The figures for missed appointments are totally bogus. They simply assume that a missed appointment costs the same as a kept appointment. But the system builds in provision for missed appointments and the time freed up is, as the retired GP said, used to catch up or to complete other work. Of course people should generally keep appointments, otherwise the whole system would break down. But publicising fake figures is irresponsible.

This happens a lot at our doctors where we have a two week wait. But fines would not work. They would work for some but it would be unfair as some people would be exempt and it wouldn't work with these offenders.
I don't know the answer. Perhaps make them come half an hour early and sit through a lecture on the effect of DNA? But if they are sick can you do this? Surely in this day and age its possible to send automatic reminders to mobiles. That would help.

In our area we are always sent a text reminder from GP surgery, dentist and hospital. All of these texts have a number to reply if you need to cancel or re -book on a different date. The hospital text is always a week in advance reminding us that it costs the NHS £160 for missed appts. The GPs and dentists 48 hrs in advance. How difficult can it be for some people to miss these appts I really don't" get it. In our dentists waiting room they have a big notice up showing how many people missed their appts in the previous month, ....not single numbers, not double...but triple. I think they should be fined or given a warning they will be removed if it happens again. Not that many years ago people were queuing around the block to get registered with a dentist in many towns as there was a shortage, now it's seems it the other way around and it's GPs in short supply. Quite recently on our local TV a GP was explaining the difficulties of getting more GPs in our area, where the population is bursting at the seams.

Retired Speech and Language here. We often talked about how a refundable charge would improve attendance. However, realism won in the end. We would have had to employ an accounts clerk at a Band 3 pay grade. Poorer people would be less likely to make a much-needed appointment in the first place. How do you chase the debt? How does it affect the clinician-patient relationship? As GPs above have said, we used the 'no-show' time to write reports, score tests and plan future sessions. No, charging is probably not the answer, but giving patients an idea of how much services actually cost might help them be more responsible about cancelling when they can't make an appointment.

I agree to a certain degree. If there’s no valid excuse then yes. However I have a chronic illness which fluctuates greatly, I can have an appointment booked with a certain Dr for continuity( my GP for over 30 years) but I can wake up and feel fine. Generally I ring the day before but have contacted on the day so the appointment never goes to waste

I think it is good that it is being highlighted in the media, hopefully it will make people think a bit more.

I do think the hospital situation is very different to the GP one. Hospital admin does seem to be rather chaotic and, because hospitals are paid per transaction, they are not as efficient as they might be. Some examples:

1) DH was sent an appointment for a bank holiday and a few days later got a letter changing it due to 'unforeseen events'
2) DH had a suspicious mole, was given a hospital appointment where it was removed and sent to the laboratory. Job done, A friend had a small growth on her eye, was sent to the hospital where they agreed she had a small growth and sent her away to wait for an appointment. It was a small matter to remove it so surely could have been done at the same time? I had a small growth in my mouth, hospital appointment came, doc agreed I had a small growth in my mouth, I had to wait for an appointment to go and have it removed. When this was about to be done I asked why it took 2 appointments, the answer was that the doc may have thought it was a different size to the dentist. What would have been the difference in treatment? None at all and that was the third person looking at it. My GP said the only reason was that the hospital got paid for both 'transactions'.

Sorry, gone off topic. I do think that there are parts of the NHS which could make efficiency savings.

A substantial charge should be made for missed appointments at hospitals and GP surgeries unless there is a very good reason why the appointment was not kept.

From a different perspective, what happens to consultants and surgical teams time and costs when a planned opp is cancelled on the day because there is not a bed due to emergencies? SIL was cancelled 4 times after actually attending and waiting at the hospital.

What's the betting that those who don't turn up for their appointments are the ones who shout the loudest about the appointments system ? The biggest moaners.

I think there are many reasons why appointments are missed, not all of them the fault of the patient. I do not believe charging is the answer, and would be a slippery slope to introduce charging for other treatments, apart from admin costs. Most surgeries and hospitals remind via text these days. We usually have about 3 reminders prior to appts. Hospitals used to overbook appts presumably because some wouldn't turn up, not sure if that happens now, but you usually have a long wait. GPs only allow about 10mins per consult, so that is in effect overbooking.

There was a GP on local radio a while back talking about this subject. His theory was that it would not be cost effective, take up too much admin time plus some people would ignore the charge anyway. It would then be costly to recuperate.

It appears that one solution would be to put those people to the bottom of the list. If there condition was serious it could cost the NHS more as they would have worsened and need more treatment.

In one of our larger hospitals in the orthopedic dept. if you cancel three appointments you are referred to your GP yet the strange thing is they regularly send out appointments and then cancel them!!

My husband used to go to an osteopath and I remember one hot sunny day he did something and was in agony. I rang the osteopath for an appointment expecting at least a coupe of days wait. She said can you get here in half an hour. She must have sensed my surprise and said ' you wouldn't believe the number of cancellations or no shows we have when the weather is good and it's holiday times- people forget their ailments!'

Missed appointments don't cost the NHS money because GPs are paid for the number of patients they have on their books, whether they go to the doctor or not.

What they do cost is inconvenience to other patients who have to wait longer for appointments. It's currently a 3-week wait at my GP practice, and I know that's a lot better than many.
It's actually been shown that notices in waiting rooms showing the number of missed appointments don't actually reduce the number of DNAs and sometimes increase them. Text reminders or phone reminders are much more effective.
Because of the phenomenon of social reinforcement, when people see these notices, although the sort of people who wouldn't miss an appointment are shocked, people with more chaotic lives who are more likely to miss, get the subliminal message that because so many other people miss their appointments, it doesn't matter if they miss them too.

I don't think it helps that often these days practices are situated in weird places. Our practice used to be next to the library in the middle of the village, near the shops and the bus stop.
Then it moved to an industrial estate, not on a bus route and you can only get there by car or taxi and for many people it's too far to walk from the middle of the village where the public transport is.