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?

I worry about things becoming more punitive, whilst it gets harder and harder to access appropriate care.

There has to be somewhere for people to access care. In my town there used to be a walk in centre. Now there's not, there are three week waits for appointments and limited referrals for serious issues, plus next to no mental health support.

Same here. Hundreds of missed appointments.

I know two people who missed their appointments because 'they forgot'. 🙄

I got an absolute bollocking for missing an antenatal appointment - I was giving birth a month early at that very moment.

otoh the misuse of doctors and a&e is huge. I had to go to a&e with a dog bite. I waited only about 5 minutes. They told me I was the first genuine case that morning. The woman in front of me at reception had a cold “My nose is running and I couldn’t sleep” and when they said it would be a very long wait she said, “Well, I’ll go home and then can you call me when it’s my turn?”

This

How many of these people have you experience with? For example I know someone who forgets he put his dinner in and it burns, who goes upstairs and forgets why, who leaves for the shop at 6pm Sunday and mows his lawn at midnight. If you can't physically turn over how do you reach the bloody phone.
Are you really saying autism can be cured? I don't think you understand much about any of these conditions. Luckily as I said the GPS I know do, and are very equality minded ....I think you should read up about the law around inclusion and reasonable adaptations.
You do know even employers have to adapt their practices for not just physical disabled but people who are ND and your attitude would send you to get training.

I'm someone who missed a bunch of appointments in my younger days with mental health problems. I got dropped from the service due to missed appointments. I totally understand why, but it's a catch 22 when the reason you miss the appointment is the thing you're trying to get help for...

Now I'm very thankfully much much better, but there were times when I just couldn't get myself out of the house. I couldn't phone - I couldn't bear it - and you couldn't cancel by text.

Truth be told, when I paid for private therapy at £50 a pop, I did not miss so many appointments. But I did miss some still - money wasn't a total deterrent, I probably missed half a dozen over a couple of years, so several hundred pounds.

It's difficult because the danger is you're penalising people who are fairly likely to be the most vulnerable in society- whether that's mental health, or for example, my 96 year old nan who does not have a mobile phone or internet so does not get all the reminders / easy ways to cancel etc.

Where is the line? Do you means test it, like if you pay for a prescription, you pay for a missed appointment?

I don't know, I feel uneasy about it.

Do your GPS call on time? Ours typically call whenever they get to you on the list so no account given for you might be driving or working where you can't access a phone 30 minutes before an appointment or an hour later.
As I've said ours have notes so they do know if someone has a valid reason to miss an appointment.

I'm surpised it's a thing. Our GP practices have been doing this for years. Three strikes and you are out. I totally approve.

It does need to be looked at however I need a routine appointment requested by Gp so have a 3 week wait so yes people not turning up .

i had to once take my Ds to see on call Gp as he was deteriorating before appointment . I cancelled with receptionist that night his appointment - I then the next day needed him to be seen again ( he was admitted to hospital ) the on call Gp read out a note added to Ds’s record - stating I had failed to attend appointment but then was booked in to see the on call - I did ask for it to be amended and it was .

How often does the typical patient go to the GP?
Do most people even go 3 times a year?? I get that people with long running health issues need frequent appointments, but the standard person on the street? Certainly in this house we are fortunate enough to typically not see a GP over a year.
Infact, thinking about since we moved to this house in 2019, I've had 2 smears, and DS has been once for infected eczema. So, 5 years, 3 appointments between the 4 of us.

The average patient visits 3.3 times a year , frequent attenders around 16 times a year.

You know someone who forgets they have something cooking in the oven? How often is that happening, because that is a fire hazard and sounds like they need a carer.

Nowhere in my post mentioned that autism can be cured. People need to learn how to navigate life using whatever coping mechanisms work. If none work then they need additional support from someone who cares for them. No work adjustments can be made for someone who just forgets to turn up or turns up late.

What the pp describes is not unheard of. Common issues such as depression can cause quite pronounced memory impacts, plus it can be a side effect of medication.

Not sure about the word 'typical'. What you're saying is you have good health at the moment. Is being unwell 'untypical'? No.

If you develop a disability or health condition your GP usage will go up.

Given one in two people will get cancer, one in four in any given year will have a MH condition, one in four working age adults (rising to almost one in two in older age) have a disability plus everyone ages, needing the GP more than you do currently can also be considered 'typical'.

Everyone would love perfect health, but humans vary and using the word 'typical' to only mean zero health concerns is inappropriate.

If it is easy enough to cancel should you not need or not be able to attend, fair enough in my opinion.

People with these conditions don’t solely live in countries where healthcare is free at the point of access. Many countries charge for GP appointments and have penalties for missed appointments. Funnily enough, the majority tend to make sure they notify if they’re not attending

For those that truly can’t, exemptions are made. But constantly going on and on about the very select few that would be disadvantaged is disingenuous as the overwhelming majority are complete pisstakers and just don’t bother cancelling because there is no consequence

My 16 year old son forgot to attend a dentist appointment and was warned if he missed one more, he would be taken off their patient list. So they only give two strikes, not three!

For telephone appointments, a second chance in the same session is fair. Our GP gives a 3 hour window and it literally just takes one toilet trip to miss it. For someone with caring responsibilities, it is a very long window to make sure you don’t miss a single ring.

Morning long or afternoon long slots in which the doctor will call you are largely unmanageable. Your boss calls, you need a wee, you are in a meeting etc

If you have accepted an appointment at 1410 and then are not free for the call, that’s different

People need to learn how to navigate life using whatever coping mechanisms work. If none work then they need additional support from someone who cares for them.

Not everyone has such a person. Or they have such a person but that person is also working and running their own life etc.

At mine, it is one strike now, since they were taken over by a chain. Basically, they want all patients to be private not NHS.

Good idea, when I did a gp job around 30% of my patients didn't turn up it was v frustrating when so many are calling up for appts

Yes all Gps should be fining for missed appointments and taking people off the books if they miss without letting the GP know. Maybe not if it's a really rare occurrence and they let the GP know, but 100% for repeat offenders. I'm sure the GPs know who might find it really hard.

Fair enough, but surely they could phone and cancel so someone else could have the appointment. Simpy not turning up is not acceptable (unless as a pp said they've been taken seriously ill).