To think that if you cancel on the day with the NHS, you should be put to the bottom of the list?

Department secretaries? They don't have those at my hospital. According to one of my consultants everything is handled by a central pool of admin people.

When I see one of my consultants she is frantically typing the letter as she is talking to me. It is pretty rushed and not very productive. The fact that I am getting worse and struggling is documented, but that is about it.

I have run out of my medication. I can't have any more until the blood results are available. The blood tests for which they didn't give me the form. By the time I got the form there were no phlebotomy appointments available online. You can't speak to anyone, so I logged on every day and eventually got the first available appointment 10 days after I should have had the sample taken. Then we had a bank holiday.

Criticising patients for being flaky is a bit rich IMO.

You are assuming there that everyone has smartphones so can use apps. My 90 year old mother doesn't. She lives alone and relies on letters. Because of her terrible and degenerating eyesight she has to wait for either her carers or my sister or I to be there to decipher them for her.

Very often the letters arrived or were even sent after the appointment should have taken place. There can also be umpteen different letters about the same appointment, issuing it and cancelling/rearranging it dozens of times that interpretation becomes very challenging. I recently went through an avalanche of NHS paperwork for her and ended up none the wiser about what the appointment was, where or when. It was totally incomprehensible. It's utterly ridiculous and we could easily miss an appointment because of it. We simply wouldn't know, and so few of the phone numbers they give in the letters actually seem to work or ever get answered.

The NHS needs to get its own act together. That would certainly help a lot. It might not get away with attempts to fine people until it can prove that it isn't at fault itself.

I suspect you were expecting full validation for your originally cryptic first post and then you felt defensive when people also began pointing out the flaws in the system you are working in. I'm afraid they do exist.

My DH was recently supposed to be seen very urgently by a consultant because he needed to start a certain medication absolutely immediately if it were to be effective. We got told by hospital admin that their waiting list was 14 months long and even if marked as urgent you could be waiting many months. We only managed to solve that because we had been given a direct phone number for the consultant's secretary, so got a message directly to him. He solved the problem, but only by double/triple booking himself on his clinic appointments so that we could be seen within a week, as he wanted.

The whole system is tottering. Sometimes it is patients being twats, but not always.

Yep. Very eye opening how horrible some of the comments are.

If this happens a lot, as others said speak to the secretaries of that department. They can see when an appointment letter was printed and can then lodge a complaint if they are being printed but not delivered. People can help if they know it’s an issue.

And nothing ever goes wrong with that system? Sending is never delayed, names and addresses are never wrong, post is never delayed?

Sadly this can happen in certain departments when they are just all booked up. Some departments can have waiting lists over a year long.

'OP you’ll soon learn that the NHS, and admin staff in particular, are despised by Mumsnet on the whole. See above'

It's true. The nastiness on this thread has been really something

@Dr13Hadley not all, but most. The op is not saving lives they are literally typing and sending letters. It’s not that hard isn’t it? Yet people still mess the basics up.

I have a chronic illness and have cancelled on the day before due to waking up in agonising pain and physically being unable to manoeuvre around my home - let alone make it out the door. I must assume a lot of people are in the same boat where the health conditions you’re being seen for prevents you from making the appointments. I will say they have got good in the sense that if you physically can’t come in, some places will allow a quick phone call to make up for it - so there’s no harm in asking for that instead of cancelling altogether.

Even things like with my child, my son is autistic and as we went to walk in down the road to the dentist he had a severe meltdown to the point of hysterical crying and laying on the floor and not moving - so I had to cancel.

It really isn’t a one size fits all and I can assure you most people have a reason for cancelling because we all wait months, or often years for an appointment- they’re usually highly anticipated. So to cancel, most people have genuine reasons for doing it instead of ‘not turning up’ like people try and make out it is

Wow.

OP you’ll soon learn that the NHS, and admin staff in particular, are despised by Mumsnet on the whole. See above.

I’m in Wales. DD’s neurodivergence appts arrive by letter. Recently referred for a scan, appt for which arrived in the post. NHS Wales app only shows my personal data, not any appts.

The referrals may be through an online system, but I can’t see or rearrange any appts online.

My mum has 'missed' about 5 NHS appointments over the last couple of years. 2 of those occurred when the appointment letter arrived after the appointment date - one was even dated after the appointment date! 1 was when the hospital transport had so many patients to collect that despite being collected at 7:30 for a 11:30 appointment, she didn't get to the hospital until 12:15 and on another occasion, the transport didn't turn up at all. On the final occasion, she received a letter cancelling the appointment and was given a new appointment time. Unfortunately, it seems nobody told the doctor that her appointment had been cancelled. She is 85 years old and doesn't use a smartphone, so no access to any apps. When she has asked for her appointment information to be texted, she is told it is not possible.

'Well why chase? They obviously don't want the appointment and wont attend so seems a waste of time'

It was a children's service. We could have discharged them, but they would just end up being re-referred and the whole cycle starts again. We had to discharge some patients eventually for non response, but chasing in the short term did avoid some lengthy extra admin in the medium term

Or look at it the other way, only been there a week and can see the high number of appointments, and ultimately resources, go to waste because people don’t or can’t get themselves there. I imagine that after time spent in the job it just becomes normal and accepted when really it is not acceptable really given how strapped for cash the NHS is.

Well why chase? They obviously don't want the appointment and wont attend so seems a waste of time

Never heard of these happening after over 35y of NHS work. I would be interested in where these fines are being implemented.

Though I am a little sceptical of a new, presumably junior member of staff knowing quite so much about the high level management workings of the NHS.

Everyone’s and expert once they’re through the door.

Yes - that's what I'm asking you.

Who fines them if they cancel on the day?

According to your first post, you are in your first week there, I think it's a bit too soon for you to be an expert on the way things are done everywhere.

'While I admire your initiative and obvious good intentions, as a retired NHS manager I think I'd say you were not using your time as a band 7 clinician very well.'

To be honest, I don't disagree with you! But it was a case of sending out letters with pre-booked appointments and chasing those people who did not attend, or giving people a chance to book their own appointment and reducing the chances of them not attending, and having fewer people to chase overall

I do take your point that my good intentions were masking a problem with insufficient admin cover. All of my clinical colleagues did lots of admin, to try to avoid situations like letters arriving at patients homes several days after the appointment date, like loads of posters have mentioned on this thread. The NHS runs on this kind of above-and-beyond goodwill, but I agree that it's not always very well thought out or the best use of time. It's just constant firefighting, and trying to make so many situations a bit less shit for all involved

Cancelling for nerves, is not an acceptable one, nope.
But... there are so many legit reasons: letter did not make it or just arrived a day before or on the day ( it happens OP, I have experienced it) and there is no time to take day off/ get to hospital, you are dead ( because the waits are long....), you already had the issue sorted ( because the waits are so long that the tests do not longer follow a logic order....), you have already being diagnosed with a major health issue derived from not being seeing earlier, you experience extreme bad mental health due to being left to deteriorate for months....

OP, please keep going strong. Really patients are put through the grinder these days. The system is letting everyone down big big big deal.

I remember getting the "can't change more than X times". I hadn't; it was the first time I'd rung to change it (for DS) after they had changed it about 4 times!!

Has somebody told you that they get "fined"? I'm not sure what you mean