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Unacceptable

(94 Posts)
BlueBelle Wed 02-Jan-19 08:34:31

I believe it is totally unacceptable for the NHS to lose so many millions a year down to unkept doctors appointments In the days when we all have a grumble about waiting so long for a doctors appointment thousands of people don’t bother to turn up blocking up that space and leaving the doc being paid for an empty space
I truely believe people should be fined and if the argument comes back that the people missing the appointments are the ones that can’t affors to pay well maybe they d be more careful the next time It is not fair on the NHS or genuine patients

Chewbacca Wed 02-Jan-19 08:43:11

Completely agree with you Bluebelle, particularly as the majority of GP practice's have a text message reminder system that they use to remind patients of the date and time of their appointments and asking them to let them know if the appointment is no longer required.

EllanVannin Wed 02-Jan-19 09:01:00

I agree BlueBelle.
I used to be involved in organising follow-up appointments before I retired from the NHS and even in the 80's and 90's the amount of people who didn't turn up was shocking and also frustrating when a consultant was given their quota of patients while you had people phoning asking if they could be " squeezed in ". Those ones had to be refused as because the consultant had already read through the notes of those who would be attending ( about 40 at a clinic )
Annoyingly some of the 40 wouldn't turn up and their absences ( most without having rang their reasons ) could have gone to those who'd previously rang to be seen.

Cancelling on the last minute isn't acceptable either as appointments are booked at source and many were important------post-cancer checks.

Nobody realises how much " trouble " missed appointments cause especially if those notes happened to have been in the hands of a previous consultant then appear to be missing. It used to be like detective work tracking those case-notes from previous appointments. This is behind the scenes work and when that patient doesn't turn up you feel like throwing your hands up in the air.

Grammaretto Wed 02-Jan-19 09:21:35

Yes another one who thinks if you have an appointment you keep it. The NHS dentist can charge and does.
Ignoramus that I am, can someone tell me: in 1948 when the NHS began, teeth, feet and eyes were excluded so these bits have always been subject to a fee and a fine for a no show?
DH has hospital appointments and we get a phone call in the morning to see if he's well enough to attend that day. It must be time consuming for the staff but worthwhile in managing resources.
Our GP has a longish wait for appointments but you can get same day for an emergency/child. They also do telephone consultations.

Jane10 Wed 02-Jan-19 09:24:49

I used to hold clinics in GP practices. Behind the reception counters there would be large notices pinned up stating how many failed appointments there had been each month. It was invariably in the hundreds.

mumofmadboys Wed 02-Jan-19 09:29:44

Retired GP here. I have to admit GPs breathe a sigh of relief if someone doesn't turn up! It gives a chance to lessen the amount of time you are running behind, make a swift drink or go to the loo or get a referral letter written from a patient you saw earlier. Certainly no GP is left twiddling their thumbs wondering what to do. We had about 35 -40 patients booked in on a routine day ( a lot more if dealing with emergencies) so if 1 or 2 don't come it was always welcome!

trisher Wed 02-Jan-19 09:34:20

It's fine in theory but how would it work in practice? How could you make someone pay? Would it be more expensive to collect the money if there had to be legal proceedings? So it might cost more than the missed appointments. Personally I'd go for dropping people who DNA back to the end of the waiting list unless they have a real valid reason for not getting there. It might mean some don't get early enough treatment but if they are missing appointments they wouldn't get treatment anyway.

MrTumble Wed 02-Jan-19 09:37:28

There is no excuse for not turning up for an appointment. If someone is unable to attend they should phone and cancel.
If not then no new appointment should be given. I also agree there should be a fine. My surgery also has a sign showing missed appointments a week always high in double numbers.
smile

Alypoole Wed 02-Jan-19 09:42:49

I heard this on the radio once : when making an appointment you needed a credit card payment but this was only taken if you didn’t attend.

trisher Wed 02-Jan-19 09:45:37

OH No Mr Tumble is on GN. My DGCs will be so excited
www.youtube.com/watch?v=iyIDg6m4gA0 (for those who don't know)

Teetime Wed 02-Jan-19 09:47:31

I absolutely agree about not wasting appointments and its selfish not to keep an appointment and deprive others of the slot. Also allowing your symptoms to worsen when you could have had a consultation is reckless. However - this is an accountants argument re the money. If a GP is contracted to lets say a four hour surgery and 24 of the 25 booked patients show up - how is that a cost? Help me here?

Nonnie Wed 02-Jan-19 10:16:50

Why do some people have no understanding of the importance of either keeping the appointment or cancelling it?

DH didn't go for his doplar (is that how you spell it) scan and the surgery phoned to ask why. I looked in the diary and it was down for the following day, his mistake. I apologised profusely and so did he when he came in and I told him. The surgery staff were lovely and laughed at us for our grovelling apology, they said they knew we didn't do this sort of thing because they knew the ones who did.

The other point of view is about hospital appointments. A friend's elderly mother was sent an appointment but couldn't go on the suggested date because she had no one to take her. When friend called she was told that if she didn't accept the alternative appointment there was no option other than to be crossed off the list. Imo there should be a little flexibility with these things.

aggie Wed 02-Jan-19 10:22:46

I was under the impression that teeth were included in the " free" treatment at the start of the NHS , some people went along and got dentures for the first time ?

lovebeigecardigans1955 Wed 02-Jan-19 10:27:33

I agree with you OP about this. It has always puzzled me as to why folks don't turn up. Perhaps they're not that ill then, or the opposite - too ill to get there. Or simply forgetful and disorganised? I'd love someone to come on here to tell us why it happens.

inishowen Wed 02-Jan-19 10:28:31

My GP is always running late and keep patients waiting for up to half an hour. A missed appointment might give her a chance to catch up. I don't see how it costs them money.

Pat1949 Wed 02-Jan-19 10:32:54

Yes, I totally agree. After all it's only a phone call, as soon as possible, if an appointment can't be kept.

PECS Wed 02-Jan-19 10:33:24

I suspect the cost of setting up a system to fine people would be as costly! Also forums like this and the "soap opera" press would be full of minority stories of the old person found dead in their bed who was fined for a no show or a person, with a mental illness, who had missed 100s of appointments etc etc.

Farawaynanny Wed 02-Jan-19 10:42:11

It costs the NHS money because GP’s are paid per patient episode. Be that a consultation, blood test, diabetes check etc. Gp’s are not employed by the NHS and each practice is run as a business.

Riggie Wed 02-Jan-19 10:43:24

I agree inis. Same as at the hospital- my son had had the first appointment of the day and been kept waiting for an hour - and that's in a department where they are not dealing with emergencies!!

janeainsworth Wed 02-Jan-19 10:46:35

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.

Niucla97 Wed 02-Jan-19 10:47:58

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!'

Lazigirl Wed 02-Jan-19 10:48:08

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.

EllanVannin Wed 02-Jan-19 11:07:32

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.

Hilltopgran Wed 02-Jan-19 11:09:36

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.

mabon1 Wed 02-Jan-19 11:16:57

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.