Why flu to GP?

Whilst out last night at my whist group, one of the ladies obviously had either a cold or the flu coming on. She actually took medication while we were playing. I must admit i felt quite annoyed at her lack of consideration for anyone else at the club, many who are very elderly and have health issues already. This is how virus' are spread, i will not be happy if i end up having caught it from her!!!

The GP's must have some idea which patients are constantly making appointments for minor ailments. I agree that a fee should be charged if they do not turn up for an appointment and haven't rang to cancel.
I think it was much better years ago when you went to the doctor when you were ill and got to see someone on the day. If you were ill enough that you couldn't get out of bed the doctor called after surgery (now people ring for an ambulance).Booking days in advance means people often feel better and don't cancel.

A charge would dissuade those who are already resisting advice to visit a GP; somebody like my elderly mother has to be frogmarched in. It would end in a doctor having to visit.
What about those who are already immuno compromised?

maryeliza I listened to the 'More or Less' podcast that explained why the true cost of missed appointments was far less than the advertised figure.
I'd recommend it to everyone - Tim Harford is excellent at explaining complex numbers in a simple and understandable way and I usually learn something new.

Yes, I understand that Jane

My dd has flu like symptoms 2 weeks before Christmas and lost a week of work. She was still coughing and despite beginning to feel a bit better at Christmas began to feel unwell again. Because of her job she needed to be sure she was ok so went to Dr last week. She was told the cough wasn't on her chest and would eventually go. It is now beginning to abate and she is feeling more human. I think if it wasn't for her job she would not have gone to Dr.

Barmyoldbat I am inferring a one off fixed charge, say £10 or £20 with no ongoing cost. The amount is just sufficient to deter time wasters who could easily get advice from a pharmacist.
I have had cancer and a pulmonary embolism and am now crippled with back and limb pain and finding it almost impossible to get an appointment.

Meg Those are fixed costs though. They occur whether or not the GP is busy seeing patients all day or going on courses or on holiday or simply twiddling his or her thumbs.
They're not affected by whether a particular individual patient turns up or not.
All those costs add up to the costs of running the practice, but it's misleading and inaccurate to imply that if Mrs Jones forgets her appointment, she personally has cost the NHS £140 or whatever.
It's not as if the practice receives £140 for each patient visit - they don't.
They actually receive around £136 per year per patient. So the more often you go to your GP, the less they are paid per visit.

If you wrote down all your own costs over a year you would be surprised just how much per hour it takes to run a family home.

The ‘costs’ involved are worked out taking into consideration many other costs that many simply don’t think about. These include heating, internet and phone bills, admin costs, equipment, upkeep of the building, insurance, cleaning, and so on. Where all these are fed into the equation then the total amount is divided into smaller units such as a the cost of a 10 minute appointment.

The reason I wanted to challenge not just the figure per se but the actual concept was because I think we are as a nation, very innumerate and statistically very unsophisticated. Politicians and other powerful people and institutions including the media, use figures like this to deliberately mislead and as propaganda. Whenever figures like this are quoted we should stop and think. I listen regularly to More or Less and it abolishes many myths like this regularly ( as does fullfact and C4s fact check). As for the problem of missed appointments, I think practice managers should ( and in some cases do) write to serial offenders bearing in mind however the individual circumstances of the patient

Whoops! My maths is out. In the above calculation the GPs would only have to provide 10,000 appointments for the cost to be £100

I think that when figures are quoted for the ‘cost’ of a missed appointment, the calculation is done on the basis of the cost to the NHS of providing that service.
So if a practice receives say £1million of funding which is spent on the GPs’ salaries, and the GPs at the practice provide 100,000 appointments a year, the argument would be that each appointment costs the NHS £100.
Of course it is a lot more complicated than that because there are other income streams such as payments for different clinics, meeting targets etc, GPs do lots of other work besides seeing patients, and other staff besides GPs are providing services.
So I don’t think you can really put a financial cost on a missed appointment.

Interestingly research has shown that all those notices in waiting rooms about the number of missed appointments are counterproductive, because the subliminal message is that because 350 other people have missed their appointments that week, it’s ok for you to miss yours too.
Obviously that doesn’t apply to Gransnet members who wouldn’t dream of missing an appointment

I'm an early arriver for everything too Baggs and at our surgery often go in (and out again) before my appointment time. It has happened at the dentist too. I was born two weeks early and my Mum said that was why I was always early for everything thereafter!

I don't believe any GP would sit twiddling their thumbs to cover the ten-minute slot of a no-show patient so I agree maryeliza that the cost quoted of missing appointments seems fallacious. It is a valid point that those who have been unable to get an appointment have been affected by the no-shows though.

If you don't want to mix with the nasty bugs in waiting room you could sit in the car and ask receptionist to txt you when your turn comes.

But the dentist I had before at this same practice (now retired) did the same thing. Once the receptionist rang me to ask if I could come early because someone had cancelled. It would mean the dentist could go home early if I could. Naturally I tried to oblige.

In an age of easy communications, it does seem particularly rude of people not to call and say they won't be at their appointment.

I suppose it wouldn't work if people don't arrive for their appointment until the last minute. I'm an early arriver because I hate being late for anything.

I turned up early for an NHS dental appointment recently. I was seen early and out the door before my appointment time (which was great because I then didn't have to wait an hour for the bus home). I don't know if this was because there were no booked appointments just before mine or if someone had not turned up. I'm not sure that matters. What matters is that the dentist just dealt with whoever was there.

Why can't GPs do this when there's a no-show? Why can't they just treat a 'broken' appointments list like a drop in list? Just turning up and being seen in turn of arrival used to be common practice. Is it not possible to combine an appointments list with a "see whoever's next in the queue" list when there's a gap? Genuine questions.

The point I am trying to make is that there is not an actual financial cost to the surgery. The cost is to a patient of waiting longer for an appointment. I don’t think the GPs time is wasted - they always have something to do and may as a result get home a bit earlier. I know the appointment couldn’t go to some one else at the time - it could have gone to someone else if the no show hadn’t booked it. If an appointment ‘costs’ £140 and there are 10 missed appointments, the surgery do not lose £1400 in actual cash. That’s different from a dentist who is only paid if you turn up

I understand your point that if surgery is running late then that slack can be taken up. But GPS work through until all patients with appointments are seen. Yes, that slot could have gone to someone else in the first place.

I think ‘no shows’ should be charged too.

Not beyond the wit of most people, I'd have thought

Makes you wonder doesn’t it Baggs ?

Maryliza that’s not how things are costed. That missed appointment couldn’t go to someone else because it’s a no show. How could that be filled? So that GP time was wasted..

In my GPs surgery last week, there were 35 missed appointments in three days. I went to pick up a prescription, the waiting area was standing room only, coughing, sneezing, definitely a no go zone.

But where does the £140 figure come from? I’m not arguing it doesn’t matter but I think figures should be reliable. Let’s suppose I didn’t go to my GP appointment today. That slot could have gone to someone else who has now had to wait longer. No money was actually ‘lost’ to the surgery, there was no extra cost to the surgery. The surgery doesn’t put on extra surgeries to catch up and pay doctors more so to do. The real cost of a missed appointment is to patients who have to wait longer for an appointment.

newnanny they do that at my surgery too and at the hospital noticeboards have posters showing the average cost of missed appointments. I think it was £140, but I could be wrong.

I know the NHS did some research into missed appointments and the most effective text messages. Trials were run using different text messages and the most effective message was the one that mentioned the cost of missing the appointment.

I do wonder what time and resources are really wasted when a patient doesn’t turn up - ime gps are usually running late so a missed appointment gives them chance to catch up by seeing the next patient sooner or doing some admin catch up whilst waiting such as signing prescriptions, letters etc. I suppose the real losers are the patients who could have had those missed appointments. I’m not saying it’s ok not to turn up btw