To find the habit of NHS medics and clinics running late reprehensible?

I'm sure some people genuinely don't receive letters or they arrive too late. That's happened to me.

But not all of the people who claim it.

And i'm also thinking specifically of a clinic I worked in which when I first worked there, we had an answer-machine service out of hours with a voicemail facility.

We removed it after about a year of me working there because of all the abuse left on voicemails.

I left that service 4 years after we removed the voicemail facility

And during those four years we frequently had people calling up and abusing staff after receiving a letter, saying no they did not DNA their appointment, they cancelled it by leaving a voicemail..

Except they didn;t as there was no voicemail facility anymore.

For that to work... you need people to actually want to work in the NHS.
We have rolling adverts for clinical staff... can't fill them. Nobody is applying.

I'm sure quite a few are using it as an excuse but I was nearly discharged from a service for not attending. It was only when my GP phoned them during one of my appointments to say she hadn't been receiving letters either they admitted that their administrator had left and most of the letters weren't being posted. I was on desperate need of that appointment too so it was frustrating to have had a delay for administration reasons.

When I was working in clinics I was 100% on time for my day and every appointment I had control over. And if I knew a patient was early and the room was free, I'd start early.

But patients were frequently late, most of the time with no 'sorry' or even an explanation. Not just 5 minutes but half an hour or more.

And this was for often, important assessments and on the occasions where I said, sorry you're 30 minutes (or more) late and i'll do my best to get it all done now but if I can't because it also involves room bookings, i'm sorry you'll have to come back another day, some people were fine with it and other people were belligerent or even abusive.

We had an official policy that if someone was over 30 minutes late, they wouldn't be seen but I did my best to go ahead anyway as it needed to be done and I also didn;t think it was fair for reception staff to have to deal with angry people.

But still..some people seemed to think it was a bespoke service where they turn up roughly within an hour of the appointment time and get seen because...whatever reason they gave for being late was so important.

The NHS has many, many flaws but there is a large group of people who don't respect it as they're not fined or struck off the books for arseing about and not respecting professionals time.

And don't get me started on all the liars who say they didn't get a letter or they cancelled when they didn't.

On one appointment to see my daughters paediatrician we had the first slot of the day. 5 minutes before the appointment there was a hum of panic amongst the nurses. I was asked who I was seeing. He was known for being super punctual so him not being their prior to the start of clinic had raised alarm bells
With the appointment 5 minutes late they had resolved the issue. Something came up that meant that day he wasn't able to be onsite and the appointment service was meant to have switched us all to online appointments. They set me up in his appointment room and phoned me there.
By the 11 o'clock appointments he's usually about 20 minutes behind. It sounds a lot but it doesn't take many 2-4 minute delays to have a knock on effect later in the clinic session. We have had short appointments and long appointments. If her treatment is effective it doesn't take long but when it hasn't been it's been a much longer discussion. The booking system assumes most will be simple continue as we are appointments and can be completed in the time frame and that it all averages out over the course of the clinic but depending on the clinic it's a naive assumption!

Sorry but I don't buy that running an hour behind by 9am is purely because of delays in appointments that start at 8. But even if it is, they need to allocate more time to the appointments.

It's a level of delusion the whole way down the service about what's possible. Doctors being coerced into working longer hours to fit in too many appointments. Patients sitting around in clinics waiting for ages. Just schedule appointments for the amount of time they take and be realistic about it. If a doctor routinely has to work an hour or two of overtime then theres no reason to cram all the appointment times into the "standard" hours when everyone involved knows that wont be possible.

I'm not blaming any of the amazing hardworking individuals, but the system as a whole is fueled by optimism and goodwill and it hurts both the patients and the staff.

I passed out recently in a GP appointment.
I don't know how long I was out for, but I came around to at least 6 people in the room. I must have made a lot of people very late for their appointments, not just the ones for my original doctor, and I still feel embarrassed about it now.

Every time I see people moan about waiting for a doctor I assume they've never had to wait for their telecoms provider to come and fix their phone or internet problem.

I've spent many many more hours waiting round for that than any doctor.

Ditto furniture delivery.....hours lost.

We get 30 mins for new patients and 15 mins for follow-ups. This includes admin time - reading letters and results before they come in, and dictating letters before you forget the details after the appointment.
So, in that 15 mins I actually only get about 8 mins per patient.
My options

1. cut the number of patients I can see in any one clinic so that each patient gets more time (Just kidding, this isn't really an option- Trust higher-ups would not let me do this as waiting times would go up more and the Trust would get less money per clinic).
2. Immediately end an appointment of a complex or elderly patient when I have 3 - 4 mins left, even if there is more we need to tell eachother because "that's all we have time for folks"
3. leave my letters to the end and risk forgetting important information ( we are paper free so typing notes out will not be any quicker)
4. try to go as quickly as I can but accept that it takes as long as it takes but I am happy with the level of care my patients get, and so are they because they know they will be given the time they need.

I don't speak for anyone else. But I know which option I have chosen and I stand by my choice.

I think I’ve worked out why you’ve got high BP. You’re entitled.

How self-centred do you have to be to miss the fact that if running late, doctors are spending MORE TIME THAN THEY SHOULD with patients in order to help them with their health. Wtf do YOU do that’s so important?

Where is your magic wand 🪄?

Disagree entirely
IME of working for the NHS, clinics and appointments predominantly run behind due to patient requirements.
The allocated time slot is frequently insufficient to meet the patient's needs and the demands on the NHS are enormous.
Patients are never refused or turned away.
Thank you NHS

Actually there are some consultants that take the piss. Their NHS clinic is due to start at 9:00 but while in town they pop to the private hospital up the road to see a couple of patients then swan in at about 11 by which time patients are getting agitated due to the nature of their condition. Always manages to leave at 1pm though

Pick not lick, that would be something else entirely

You do take obtuse to a new level, whether that's deliberate or you are just a numpty I don't know. So, a) We do offer incentives and B) we aren't the only Trust with plenty of vacancies so consultants can basically lick and choose where they want to go regardless of the incentive

All of this!!

GP here. I finished work at 7pm instead of 5.30pm today, not unusual at all. I'd be absolutely delighted if all my appointments had run to time and I'd got to go home. Unfortunately the appointment times simply aren't long enough to give enough time to every patient. And yes, sometimes the first appointment of the day is running late, not because I'm late to work but, for example, an urgent home visit to a patient with palliative care needs, a phone call about a possible emergency that needs triaging, a test result that's come back unexpectedly abnormal..
I do always apologise to patients though. And I have to be honest, sometimes I'm thrilled if someone doesn't turn up for their appointment, I get time to go and have a wee!

What would you prefer, a longer wait in the waiting room or a longer wait for an appointment? If they doubled the length of each appointment slot, there'd be only half as many appointments and the waiting list would grow ever longer.

They can't pluck more doctors and nurses out of their arses, for all the reasons given upthread, and they can't control how long each patient will need. And unexpected things crop up during consultations, eg a patient might mention a symptom that is new, or which wasn't in the referral letter, and might require a test or x-ray (this happened to me a few years ago).

I go prepared for a long wait. I take a book and grab a coffee on the way in. And then I sit and chill.

I'm more bothered about schlepping 8 miles on rural roads to the hospital, paying £4 to park and still have a 10 minute walk to the clinic because the hospital has been massively extended and all the parking is at one end, only to have a 2-minute convo with a doctor and a change in medication that could all have been done over the phone.

I'm paid hourly, & if I don't work I don't get paid. I loathe the fact that their inefficiency affects me financially.

I was first in clinic once, and i was 30 minutes late ..bet that was fun.

I don’t know why they just can’t tell you when you arrive “we are running 50 minutes late” so you can manage your own time.

Some delays can’t be helped. But I was annoyed when I had a booked appointment for eye casualty and had to wait three hours after the time. As I work in the same hospital I went prepared for that. But no one else was. I can’t see why they can’t have planned appointments separate from emergencies.

Until I retired recently I was Nurse in a busy Out Patient clinic in a major teaching hospital. The following are some of the reasons why clinics run late.
The Consultant does a ward round prior to the clinic starting, a patient may have developed a serious medical problem that the Consultant has to provide guidance to the junior doctors to manage the issue. The Consultant will require updates about the patient's condition whilst in clinic.
An afternoon clinic may start late because the doctors have been in theatre in the morning and a case has taken longer than expected. The doctors might have been in a clinic in the morning that has run late, they have not had time for lunch.
A patient receives news which is potentially life changing and requires more time than that has been allocated.
A patient arrives who presents with an urgent problem, they have decided to not seek medical advice from a GP because they've an appointment at the hospital coming up. They require urgent investigation and possible hospital admission which the doctor has to arrange.
A junior doctor sees a patient and requires advice from the Consultant, the Consultant may want to see and examine that patient themselves thus delaying other appointments.
A patient turns up to clinic a week early, it's important that they are seen as they have previously not attended appointments and if they are turned away it might be months before they return, they are added as an extra.
An elderly patient needs to be examined, they have mobility issues so it takes longer to move them safely and comfortably on and off the examination couch.
A patient or relative faints in the consulting room, they need time to recover.
A patient needs an interpreter.
It's a teaching hospital so medical students may be in clinic, they require supervision and teaching from senior doctors.
There are many more!

My clinic often runs late. I’m a midwife and women frequently arrive a few mins late, check in and then go to the bathroom to provide their urine specimen resulting in me waiting for them. Someone may require referral to daycare or triage for an urgent concern. I may need to call a different hospital to arrange an induction of labour. A safeguarding concern may arise, someone may feel unwell getting bloods taken. A woman may be upset or struggling and need more of my time and it’s not appropriate to tell her time is up, I may need to utilise a language line interpreter and even getting someone on the phone can take up valuable appointment time. Some women come to each appointment with a list of topics they wish to discuss. I often have a student too and this can result in the appointment taking slightly longer. I try my best to keep to time but ultimately women’s needs are unpredictable and I strive for all my clients to feel they have had my attention and care to meet their meets. If I know in advance someone is likely to need more time than the allocated appointment I do try to make arrangements to see them out with clinic times. Luckily most clients understand. I know as a patient it’s frustrating and I’ve experienced long waits at clinics myself but working in the system I know most people are doing their best.

I don’t think I’ve ever had a doctors or dentist run on time. Could be the first 8:30am appointment and turn up before the gp / nurse /midwife.

There should be more incentives for nhs doctors / nurses / midwife’s. It should also be a free uni course with housing on a contract deal of working for the nhs for X years in return otherwise costs are to be repaid.

And more flexibility in the hours. Not just a your a rota staff oh well. There should be midwifes who work just a morning or an afternoon or nights only or 9-5 or whatever. Retaining staff by having better conditions and being able to take their breaks.