Missed appointments at the GP

[Tamega]

Our gp practice started to warn patients who have missed more than 3 appointments in a year. If they miss another they will be removed and a note added into their medical records.
What do you think about this?

Our local nhs physio team had 24 appointments missed last week including 5 new referrals.

Thank you. Very interesting. People who want to cancel don't even bed to phone. They just need to click cancel on the text reminder received and it will be free for another patient.
I am glad I am nit the only one. Last month they had 310 missed appointments. People who just can't be bother to cancel.
And even if they have mental health issues, they can easily press cancel to free the appointment. No need to call and speak to anyone.

I am very careful not to miss any appointments and am paranoid about having them all on my Google calendar. Overall, I think the system you are describing sounds fair providing it is applied with common sense.

Many years ago I did once miss a hospital appointment because I didn't receive the letter telling me about it in time. In fact, the letter itself was dated a couple of days after the appointment was supposed to have taken place. So an admin error by the hospital, but with the best will in the world, I cannot attend an appointment I know nothing about.

On that occasion I did manage to get them to remove the Did Not Attend note that had been recorded against me. I only had to produce their own erroneous letter for them to capitulate.

Surely in those cases you would ring and cancel? Somebody else could use a last minute slot.

I have been stuck at home with ibs many times but I wouldn’t just not call.

Also, in my practice one GP had 15 missed appointments in one day. This is totally unacceptable.

Yes, I think it’s a good idea as long as they are actually missed appointments. My hospital consultant tried to send me for urgent bloods at the GP today. GP refused to do them as they wanted hospital to deal with it. Hospital said, sorry, you’ll have to come in, which is an hour away. When I got there, I’d gotten a call from the GP saying, never mind, we’ll see you after all for an appointment in 5 minutes, but I was an hour away at the other appointment the hospital made for me. I did ring but pretty much cancelled like at my appointment time. I wouldn’t want that to count against me, as I was only doing what I’d been told to do.

In most of these situations you would still be well enough to cancel even if you were doing it from bed.

people who struggle to manage time need to find mechanisms to cope in the world and can’t expect people to just sit waiting around for them.

I suppose by the same note we can't ever hold anyone accountable for anything, we can just make up excuse after excuse after excuse.

I think it sounds a good idea in theory but hope they'd be taking care to record these "misses" accurately.
I remember, years ago, calling up about my (then) baby son who was unwell asking if I should bring him down to the emergency drop-in clinic that afternoon (He's now 28 so we're talking different times and protocols). They said to "see how he goes and if he doesn't perk up by then, by all means bring him in."
He did perk up, so I didn't go. Next time I went with him for something else, I saw on the screen I/he was listed as a no-show. I queried it, explained the situation and asked for them to change it. They said no, that it "qualified."

Tbf if I managed to get three appointments in a year at my GP as opposed to a text message giving me information I'd already told them I had and wasn't relevant, then I'd be surprised.

That's utterly ridiculous!

What a total waste of appointments!

“And even if they have mental health issues, they can easily press cancel to free the appointment. No need to call and speak to anyone”. Said as someone who has never had serious mental health challenges! In theory this is all well and good but it’s simply not reflective of the challenges that some people have in accessing health systems, or the fact that the NHS has serious incompetence around booking systems . I’m a HCP who has worked with the type of vulnerable ,mentally ill ,illiterate and elderly people who struggle with accessing appointments and myself have had 3 occasions where I or my child has been discharged without being seen because we were “sent” appointments that were never received. I have happily been “ sat “ on waiting lists twice for important tests only to discover I was discharged for DNA through not receiving the appointment.

It's very common in this city in Canada to charge $100 (about 50 pounds) for missed appointments.

I asked about this, at my ophthamologist. They quite liberal about waiving the appointment if the patient has a reasonable excuse. Given that it's so hard to get an appointment anywhere, I think that people make it a priority.

Bil received a phone message recently for a hospital appointment he'd apparently missed. He never received any notification. Turns out that the appointments system had been out-sourced to an external company who had cocked up and not sent ANY letters out to people for a couple of clinics (Bil's included)!!

Well yes certainly in GP surgeries they would cope!

They have a clinic list with say 10mins for each patient, the GP needs to be moving quickly through the list as they normally would be doing

A no show does give them some extra time to catch up on a mountain of paperwork, certainly not twiddling their thumbs or similar

Absolutely!

My dentist I go to is private, no NHS places locally when we moved into the area

When I have a dental appointment coming up (or for the kids) I receive reminder emails and texts

Also, I know that if I cancel with less than 24 hours notice, I will be charged the full appointment fee...so I make bloody sure I don't miss the appointment

GP surgeries could take a leaf out of private dental practices

But doesn't that mean that each GP would need to stay on at work for longer to make up for missing those 10 minute gaps occasionally.

I'm also not sure if I've ever been seen on time by a GP. I don't mind as they are giving extra time to someone who needs it or dealing with something urgent. That would get worse if everyone actually turned up.

Same for hospital appointments. I'm not sure I've ever been seen on time.

FATPOA

Free at the point of abuse is a term I've heard bandied about in the NHS

I don't think this entirely incorrect...

Good idea. People should be more considerate.
It's a shame that GPs can't charge (say) £20 per visit - yes, I know the admin would be cumbersome, but it might make people think twice before wasting GP's time.

Fair is fair.

I'm a GP receptionist, more than fair . On shift today for 4 hours and had 3 people that had missed their phone call appointment that morning and just hoped the dr could call them again , doesn't work like that 😩

I live abroad. For any doctor's/hospital/dentist, etc appointment here they tell you that failure to cancel 24 hours before will result in a fine. I've never juu not shown up to an appointment, but twice had to cancel my daughter's physiotherapy appointment attendance short notice. Once she woke up ill so I cancelled as soon as the office opened in the morning. The second time I picked her up from nursery (where they told me she had been fine all day apart from not really eating anything), brought her home chatting all the way, then as soon as we got home she stopped talking and just lay on the floor. While taking off her coat I realised she suddenly felt really hot and sure enough she had developed a fever in the approximately 3 minute walk home. Luckily both times they chose not to charge us - even though the second time I literally had to cancel an hour before the appointment. Presumably in a case like a pp mentioned where they had to go to hospital they would use their discretion in the same way and not charge.
(For the appointments themselves our health I'm pays but for missed appointments we would be charged personally)

A waiting bench for appointments would ensure any empty appointments were filled.

They've done it at a couple of GP surgeries I've been at .. pre COVID.

Agree with this. I do think there needs to be some way to cancel or amend hospital appointments though. My mum died and had an appointment with the eye clinic. I rang and rang for two weeks to cancel this but the phone was never picked up. Eventually I had to visit the hospital in person and cancel it face to face.

At our practice the doctor calls twice. People do sometimes miss calls, even with the best intentions. Especially carers, parents, people who are unwell, people who are confused.