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

Having fines or fees for missed appointments....but a list of mitigating circumstances or people who were exempt....would surely add another layer of admin to system that is already struggling to cope?

It's obvious that there are some people who potentially do abuse the system or cba to turn up, but there are multiple reasons in this thread alone, where people couldn't attend for very genuine reasons - not knowing they had an appointment being common!

I've had some appointments that seem to work really well, with a phone call or text reminder few days before to check you are attending. Then other instances where I've cancelled a appointment with plenty of notice and then been put down as DNA. And a wasted apt that I didnt need! So the whole thing is pretty lucky dip whether it works...

I think this part of a wider problem of complacency where many take the Uk free healthcare system for granted. Would this happen, to the level you observe if you had to pay for your appointment and/or treatment.

Similar challenge with GP appointments, time wasters at A & E and calling out an ambulance. One of my friends has re-trained as a paramedic and cannot believe how many time wasters there are. She reckons 6 out of 7 calls are not necessary/emergency situations and most could have been self-managed at home.

Not sure what the answer is!

excellent idea. I think the problem here is that there are no repercussions for misuse of the service, and too often no value placed on services provided for no direct cost. I know this thread is about appointments processes and responses on both sides of the fence, but I do believe that if there were nominal charges for misuse (including 'can't be arsed' missed appointments) that would tighten up a lot of slack. Ive been a heavy user of NHS services for 30 years now, and my personal experience is that poor use is much more patient side than system side,

We have worked in a profession for over 40 years, where we have to account for all our time and it’s charged to clients, via a minimum chargeable unit of say 6 minutes. I heard constantly, when I was younger:

” Why are u doing x - you are too expensive for that!”

I can assure you, we think all the time about how much other people’s time is per hour!

DH tells his clients to give three times and dates, they can make to see him, and he will make one of them!

Imo, half of patients’ problems with the NHS are, that they are given appointments at no notice, less than 48 hours notice or at times, they can’t make! We don’t get reimbursed for our wasted time, travel costs, hotel costs or sheer stress in getting there - only to have the appointment cancelled at short notice or get there, to be told no doctor is available in the field.

It’s very annoying when you have had to drive over 600 miles, and had to get someone there, with challenging behaviour and disordered sleep, who can just refuse to get up that morning and be very abusive to you - at a time, you told the department all along is too early! (And they of all people should understand just how complex the medical problems and behaviour are!)

I know someone who kept getting text messages reminding of hospital that he didn’t know about. Eventually he realised the ‘do not send letters’ option was selected on his records.

You have no idea why they cancelled.

I think you're right because I have only ever had an apology once for a cancelled appt. I was about to board the train on the day & they cancelled because two people on the team were sick - I received effusive apologies for that and they remade very quickly. Quite different from the day surgery that was cancelled (again, in a hospital miles from me) smashing up all the many arrangements that I & my daughter had put in place. The reason? I had to have another procedure first in another hospital, also miles away which no one had ever mentioned to me. Not a single sorry to had. My time (& shredded nerves) is of absolutely no interest to them.
So, yes, patient no shows are bad but I seriously doubt that they are all just slackers who can't be arsed and you can hardly be surprised if it triggers stories like mine & others. For nearly two years I've undergone two cancer investigations, one came to nothing & other was diagnosed & I'm just in the last part of treatment now (I hope🤞). But the endless chopping & changing, cancelled train journeys, cancelled hotel bookings can't have been doing me any good.
I must say that, when it comes down to the actual treatment, everything has been excellent & the staff brilliant. It's just the appointments mechanism that needs a hard look at. A friend of mine had an op cancelled because the surgeon was on holiday - surely his holiday would have been in a diary at the time the date was proposed?
I'll shut up now.

I mean, it is perfectly reasonable that the appointment was scheduled months ago and so they forgot when it was.

I was referred in September 2024. 2 months ago I chased them again for an appointment . Finally got one fur November 2025. 13 months in a waiting list.

And no, I wasn’t told of all the risks prior to the surgery day… it was so over whelming and hue to my age and type of surgery I was having it was potentially life changing if it went wrong… to be told on the day that it was a REALLY complicated surgery and each cut carried a 50/50 chance a hysterectomy was scary as hell…. Especially when in my 30’s and wanting a baby!….
I agree if you drop out you should go to bottom of list (unless it’s urgent surgery) but people shouldn’t be bullied into having surgery with threat of having to pay….. I can’t imagine feeling cornered into my having my surgery and it going wrong and loosing my womb in my 30’s!

I think you’re in the wrong job!
anxiety is very impactive on people, I went in for surgery years ago & after being given the list of things of things that could go wrong… which were - you could end up with a bladder/bowel injury resulting in needing a bag/or death… you could end up having a hysterectomy …. Things along those lines….. it’s a 5 hour plus surgery…. On top of that I’m terrified of needles…. Then they cleared off and left me sit there with my fears and thoughts for hours!!… I got myself into such a state I dressed and called my mum to come and get me!
it’s awful that people are left to sit alone for hours before surgery. It even allowed a friend or parent for company… I finally had surgery last year and thankfully I was 2nd down and nurses kept popping in and were chatty and the time went faster, and 8 years has passed since I walked out & I elected to have a more straight forward procedure this time. Still huge & I was still terrified but less risky.
Ot is inconvenient when people cancel but people also shouldn’t feel bullied into having major potentially life changing surgery by the threat of being charged.
but yes should drop down the list a bit… in my case I left (told doctor obviously) and took myself off the list completely… going back for a different but more drastic surgery a decade later.

I agree about the "patient blaming" culture - it's endemic.

My OH had a 9-30 appointment with a cancer specialist in a different city to discuss a stem cell transplant with the specialist and the stem cell co-ordinator. Waiting room full. Others were going through all morning, we were sat there like lemons. He asked a couple of times at reception only to be told "they were busy" and just wait. By around 1pm, the waiting room was empty and even the receptionist had gone for lunch. We went down the corridor where the consultants seemed to be and asked a random nurse who said the consultants had all gone for lunch - she tried to find his file, and it was left on the side. She was actually helpful and made a couple of phone calls, only to find the stem cell transplant co-ordinator never worked on Wednesdays so we should never have been given that appointment. Receptionist should never have booked us in and the appointment clerk should never have given that appointment.

A whole day wasted. Not only that, but waiting 4 hours in a busy waiting room is hardly the best for someone immunocompromised due to chemotherapy!

When he phoned to get a new appointment, the appts clerk was really off hand with him, asking why he'd failed to attend as it had been put down on the system as a FTA! Patient blaming at it's finest.

You can blame the doctors who told me parents they were imagining the problems I have. Unsure how anyone can imagine their child vomiting or having seizures

I had an appointment at a hospital about 40 min from home last year. I took a day off work, waited for over an hour after my appointment time, and paid a fortune for hospital parking....for the dr to be very apologetic that actually they didnt need to see me at all. I had been booked for a procedure 6 months prior but on the day, it was decided to do something less invasive. The follow up apt was needed (and booked) for the initial procedure but unnecessary for what actually happened , but then hadn't been cancelled.
So that wasted my time, the Dr's time, and an appointment that someone else could have had.

I can't believe half the replies on here. Are you all so thick you don't understand that a major factor in wait times and operating delays are due to arseholes not attending their appointments? And that's not even looking at the costs, all of which could be better spent.
And yes of course there are occasions when someone is ill or breaks down or whatever but in most cases it's people being disorganised, forgetting the appointment, double booking, etc and then just too lazy to admit mistake and phone to cancel . And as for unnecessary appointments all NHS services have a patient protocol to follow and if you don't want your appointment just bloody say so. It's not difficult.
Very few letters are delayed or lost in post these days and that's why they all do text messages where possible.
If I ever need urgent appointment for anything I just phone every now and again asking if they've got any cancellations and I always get an earlier slot. It would be helpful to have an online clearing system for people to use in this respect, like universities use to fill up their places.

There is a known issue in terms of the administrative tech that is used in the NHS. By the time funding is approved and a new system implemented another more efficient system comes along. Frustrating for all concerned. It needs serious Government investment to sort this and also public pressure to local MPs etc to alert when things go wrong.

Somethings amiss here. I’d advise ringing and speaking to the department (reception and the consultant’s secretary) directly to explain the issues. Sounds like various tech systems are not working efficiently enough. This helps no-one, especially you ! Hope things improve for you.

I missed an NHS appointment a few weeks ago that I had waited months for and I didn’t get the chance to notify them beforehand. My 5 yr old had appendicitis and was rushed to hospital for an emergency operation. I appreciate some people ‘just forget’ or whatever but there are also often very good reasons for it. Would you have me penalised for saving my child over myself?

Exactly. Everyone will have had the shits.

I think I’m with you on this. Some patients just don’t consider the cost to the NHS for missed (not cancelled) appointments and more importantly that someone else could have used that slot, however short notice. A (means-tested) fine system should be in place like some other healthcare providers employ to deter those who think they can just not turn up without informing first.

Also believe they should be charged for multiple missed appointments.

Surely to do this a list of reasonable excuses will need to be published and lo and behold the vast majority of cancellations, regardless of the real reason, will become those reasons.

My moving jobs was never a mistake.
Job satisfaction is not always about the money. It was difficult but my job satisfaction was enormous. I loved that every day was different and brought challenges both mentally and emotionally (patients with life-limiting conditions, cancer and of course during Covid). I advanced in my role and led a team of 12 admin staff.And for the record, applications for admin jobs require a minimum of passes in GCSE (inc English before it became compulsory) and proof at interview. I personally never employed anyone who didn’t have good personable skills, good communication skills and a proactive can-do attitude.
Anyway, I’ve said all I need to say in defence of the majority of NHS admin staff. In any work environment there will always be the lazy ones, those who take advantage (of sickness leave) etc., those who simply come in to pass the day and not engage fully and work hard, but it’s down to efficient policies to weed them out. Where poor interview strategies are in place that’s where things should change as ultimately an unproductive or poor fit for a role as you know is where things come unstuck. Please do not underestimate the pressures the majority of staff are under. There is a lot of ‘swan on the surface, frantically paddling underwater’ to get things done in the time allocated with huge waiting lists and backlogs to get through. But we always knew that a smile on our face, an empathetic ear and a kind heart would help things along.

I work in the NHS. One of the things I find most frustrating is people who don’t turn up for their appointment or cancel at the last minute to then go to a&e later that day or week with the very problem they should have attended their appointment for!

Same when you get people insisting that nearly everyone in A and E is a timewaster or there for a "sore throat, or a broken nail!" 🙄
Ignoring that a) you can't tell from looking at someone what their health issue is b) its often nigh on impossible to get a GP apt so maybe someone has waited/been unable to see a GP and their condiTion has worsened c) there may not be a minor injuries unit nearby d) they may well have been advised to go by a GP or 111. Some people might be there for no good reason, but given the waiting times it must be a minority.

It's easier to say it's all because patients are too unhealthy, or wasting time at A and E, or not turning up to appointments than try to fix the multitude of problems in the NHS.

Here in Canada if you don’t show up or cancel less than 48hrs before (some places have it as 24hrs), you get charged. The fee is what it costs the system, so a GP has one fee, for specialist different rate etc.