Rishi will introduce £10 fines for missed GP and hospital appointments

[GreenLunchBox]

How will that work, then? If you miss the phone call they'll fine you? Sounds like a license to print money to me 😂

Also so many patients receive letters from hospitals saying they've missed an appointment when they never actually received the letter inviting them for the appointment in the first place. God knows why hospitals still use snail mail. This is completely unworkable.

These two are acting like they're running for student council rather than PM of the country (see Truss wittering on about making Oxbridge interview every student that gets straight As). Tinkering around the edges and stoking culture wars when we're actually heading towards an actual catastrophe this autumn.

Also if they’re going to do that, and expect it to make a difference, they’ll have to stop GP’s and clinics overbooking

DDs clinic overruns all the time and the reason given is always “more people turned up than expected”

The thing is, let's say it's a fairly small GP practice with 3 GPs, 2 practice nurses and one other HCP (paramedic, physician's associate, pharmacist or whatever) - full time FTEs of each. So 6 FTE in total.

Most people in a GP surgery will fit 6 appointments in an hour over about an 8 hour day. GPs will probably work longer, some HCPs will have fewer appointments in an hour. Anyway that should give us about 48 appointments per staff member per day. 4856 = 1,440 appointments per week.

Even on the basis that 6 an hour for 8 hours is unrealistic - let's cut it down to 1000 a week.

30 missed appointments is still only a 3% rate and tbh I would expect it should just allow the practice to catch up on paperwork or get back to time after a complex case has knocked things off balance. Your alternative would be to overbook by 3% like airlines do and accept you'll be working late if everyone turns up. That would be about 1 extra appointment per staff member per day so not unmanageable if the practice chose to.

I think at hospitals (where patients are more likely to struggle to get there, more likely not to have chosen their appointment so can't make it, and more likely to struggle to cancel) you might see a bigger problem, but I don't have any stats to prove that.

And I’ve attempted to cancel an appointment (as had gone private due to wait) - via text as requested. I sent 4 messages cancelling it with no acknowledgement. And then got a DNA letter discharging me.

there was no other way to cancel the appointment - no phone number or email address.

id have been fuming if I was charged for that.

It's only if appointments are REPEATEDLY missed and I agree with it. A missed appt costs on average £100. The odd one, when you get caught behind nightmare traffic, fine, no problem, but if you miss five in a row, frankly, .......

Exactly!
my Dd was given a series of appointments for a minor medical issue. they sent the letters around 6 weeks ahead and the appointments were always within the school day. Occassionally I had to rearrange them, if either it clashed with exams at school, or I couldn't get that particular day off work to take her. I called with plenty of notice (at least 1-2 weeks) sometimes I spoke to a person, other times it was an answer phone. But every time we got a lecture the next time we went, about our no-show at the previous apt! 🙄 There's no way I'd even pay a 10p fine for that let alone £10 when I've followed the instructions on their letter (if you can't make the appointment, call this number) p

Everyone would be charged? Regardless of age?
Or the usual exemptions (regardless of ability to pay) of children, those on benefits, pensioners (biggest non attending group in my clinics).
The usual mugs in the middle would end up being the only group penalised.
Unworkable and unfair.

Actually getting through to a hospital department on the phone is nigh on impossible, its always engaged making it difficult to cancel or rearrange.

Cigarette packet policy making instead of the systemic change we deeply need. Doesn't surprise me from Mr eat out to help out here's a few Bob to shut up about the energy crisis Sunak

DNA's are used as catch up time. There's always emergencies, walk ins and things taking much longer than expected. That's why if everyone turns up to a clinic you can wait ages to be seen.

My local hospital never send me the letters in time, my GP book me in without asking for reviews and kids vaccines and stuff even though I've asked them not to and to put a note on the system. Plus my old GP have a habit of booking me in for things even though I changed practice nearly 5 years ago! So I'm expecting I'm gonna be paying out a whole load of tenners I don't have.

Will I get a CCJ if I don't pay do you reckon?

I agree with the pp who said it's all pretty theoretical anyway as it looks increasingly unlikely that Sunak will be prime minister, but even so this is such an irritatingly obviously back-of-the-envelope policy with no thought behind it. The admin it would create would provide a bigger problem than it could possibly solve. I also wonder if he imagines it would apply to children and the elderly? People normally want to exclude them from this kind of thing - same when people suggest introducing a charge to see the GP - but given the extent to which the elderly are the heaviest users of the NHS, by such an extraordinary margin, it gets a bit pointless and tokenistic if you exclude them. In fact it achieves nothing apart from making working-age people who are the lightest users of the NHS feel punished and resentful.

I know, but then, why not add something else to the list of what this group are the only ones to pay for!

Other reasons for wasted appointments were referred to by pp - not being given proper instructions about, e.g. fasting for a blood test, taking / not taking usual medication, bringing an early morning MSU sample, needing a full bladder, having empty bowels, having a covid test at least 8 hours prior ... all these instructions should be clearly written on the appointment letter.

I've recently had to re-book a long-term condition review because the receptionist who booked it told me X (I specifically asked about something, thinking I was being efficient), and when I got there the HCW said that I should have been told Y. It was a right faff getting there as well as I've got a damaged lumbar and needed a lot of help. Fumming I was, proper fumming. I had to be calmed down at home with half a bag of tangy worms.

So piss off, Rishi.

It would be likely to cost more than £10 in administration costs - sending out fines letters, chasing the non-payers etc etc. I doubt if it will happen.

my local hospital (SW London) - they do text when they are sending a letter out - and you can then log in and see the letter via it.

they also send you a reminder a week before and then 2 days before.

text reminder about GP appointments too. clear "how to cancel/re-arrange" instructions.

so some places seem to be able to manage it.

Our GP surgery used to have a notice up on how many missed appointments there were a month.
I think at worst was about 400 a month across all 18 clinicians rooms.

So why don't they have a drop in area. Come and sit and wait. And if someone doesn't turn up you get seen before the end of the day.

I've been sat waiting for my appointment (40 minutes late at this point) when someone was being shouted at for not getting to her appointment on time. What had happened was she'd arrived a moment too late for the machine at the door to allow her to register and by the time she got to the front of the queue to ask for help she was 10 minutes late.
I could hear her explaining she works in children's care and couldn't leave until a parent had turned up to collect their child and this had meant she had arrived later than she'd planned.

The receptionist was utterly vile to her. And all the time I'm sat there silently fuming that my appointment time was long gone.

I am really surprised that a man who was Chancellor could come up with such a stupid and unworkable idea.

Part of this I actually agree with!

I work within a specialised section of the NHS that only has a clinic one day of the week with two consultants. (Funding issue) we also join with another clinic who only runs one day a week. The waiting list is horrific and our patients live in fear until they get that appointment. The amount of no shows is ridiculous. At least one every single clinic!

Some of these patients are a nightmare. Don’t attend clinic appointments or tests on a regular basis yet they are always offered another due to the nature of the clinic. They waste our time and the publics money. Maybe something like this would either force them to attend or call and cancel, allowing the space to go to someone else.

I have to say though, after my earlier NHS whinge, every medical and health care professional (with the noted exception of my GP, but that’s a whole other thread) have been brilliant. They’ve all treated DD with kindness, dignity and patience. We haven’t had long waits for appointments and even CAMHS, who usually gets a bad rap on here, have been amazing, scooped up DD from absolute rock bottom, and when I look at where she is today compared to two years ago, I can’t thank them enough

However, the admin side of it has made me want to bash my head repeatedly on the nearest brick wall on a daily basis

When I worked in the NHS about 25% of people never turned up for their appointments. Sent them reminder letters in good time etc. So many people waiting yet these arseholes couldn't be bothered to cancel their appointment.

Receptionists and their reputation (justified in some cases, some not) are probably part of the issue, in that if you have had a difficult or vile one, I expect you are going to be less willing to make the effort to cancel or rearrange.

What about the patients who have died and still been sent an appointment, is that a good enough excuse not to pay. Its unworkable, a gimmick and will never happen.

Does a sensible policy ever pass through the brains of these idiots? They ruin the NHS and now are blaming patients

the NHS is a big bulky beast; something needs to happen to stop the constant massive leak of money and resources.
Our surgery posts weekly stats for missed appointments and it's a staggering figure. So wasteful. And zero incentive for people to cancel appointments, they just can't be arsed (for the most part, despite what people might say here about those rare, exceptional circumstances which happen also.)

Sunak doesn’t use the NHS so he has no idea what it’s really like in terms of appointments logistics. It’s like he went to a posh dinner party and someone said the problem with the NHS is the great unwashed masses wilfully skipping appointments and shouldn’t they be fined, the ungrateful peasants.