Cost of NHS missed appointments £1.2bn

[Tiredallthetimeneedsleep]

Currently in hospital with nothing better to do than scroll MN and perusing the web. Was shocked to find the cost of NHS missed appointments see attached

I would like however to say a word in praise of my parents' GP surgery.
My Dad is a 'frequent flyer' due to heart failure. The GP often books the next appointment at the previous one, and if needed we have managed to get interim appointments on the day. They answer the phones. They are a fab surgery, and I wish my own one was as good.

In all the years I’ve been under the hospital I have never had a problem with NHS administration.

Nail on the head. OH has to make 2 or 3 blood test appointments every month. One in the oncology dept, one for the gp, and one for the day treatment unit. Impossible to ring one number to make all three. 3 different phone numbers, and none of them actually answer the phone. He can spend all day phoning between them, sometimes the phone rings and then cuts out, sometimes an answerphone but he leaves messages and they never get back to him, sometimes an engaged tone. It drives him mad listening to the long pre-recorded messages and then finding the dreading answerphone or the line going dead and him having to start again.

Thing is that when he goes in person, the receptionists at each are just sat chatting to each other!

I spotted an entry on my record saying I had missed an appointment for breast screening. I have never received an appointment. I sent a message querying it and never received a response. So, based on my sample of one, I definitely believe there is an significant element of admin issues causing the problem.
On the other hand, missed GP appointments are definitely an issue at my surgery, the stats are shown on the wall at every visit, and it would be pretty hard to get a GP appointment at my surgery and not be aware of it so those are likely down to patient error. It would help if it were easier to cancel or get through on the phone to cancel.

I do think a nominal charge, say £15, for GP appointments would massively increase the availability by reducing time wasting and I would now support a fee tbh.

The oncology dept can't even organise my OH's monthly chemotherapy cycle. It's not rocket science, it's the same every sodding month. But they're incapable of booking appointments for the 4 week cycle, and he has to phone and tell them, every month, that just because he started the cycle on 20 March, doesn't mean the next cycle starts on 20 April! They don't understand the difference between 4 weeks and a calendar month! It's not difficult! He starts on the Monday every four weeks. Yet the NHS administrators are incapable. Even if he gets an appointment for the right start date, he turns up only to find they've not got authorisation to administer the Chemo drugs as it was authorised for 2/3 days hence, not the appointment date which was the official start date! Meaning they send him home which delays the treatment cycle, which has a knock on effect for the following month, so all the pre-made appointments for the following month are wrong and need changing! It's a sodding shambles.

Only if the NHS compensates for their admin cock-ups and delays etc.

Any anyway, most patients would be exempt from the "fine" - they're not going to start fining children, OAPs, disabled, mental health patients, etc. are they?

There are massive issues with the system.

My colleague had a text to say her daughter’s hospital appointment was on Friday X at 2:30, at 4:30pm on the Thursday. She had a letter saying it was actually on Monday Y at 4:30. She called the hospital and they just laughed and said “oh yes, your new letter is in the post today!”, and the letter arrived three days after the second appointment. It’s ridiculous.

I had to cancel an appointment for DS this morning. It took me 45 minutes to get through the hospital to do so. Thankfully I wasn’t in work this morning so had time to wait to get through.

I would never knowingly not attend (there have been times where they haven’t sent letters but thankfully the system of text reminders helps now!) but making it so hard to cancel doesn’t help

I’ve had letter arrive after the fact or arrive on a Saturday for a Monday appt which lots of people could easily miss with such short notice might be away etc , also the way of just giving some random date and time without two weeks notice, so I have to ring up, get another date sent out etc the nhs system is just so dated and clunky and inefficient.

Appointments should be sent by email or text whenever possible. So much money get spend on postage. Also if people need a further appointment this should be booked before they leave the hospital and they should check their email and mobile number is the same upon arrival. Ultimately if they charged £25 for missed appointments, people would be more likely to pick the phone up and cancel any unnecessary appointments.

I'm not suggesting a fine for missing appointments, I am suggesting a charge for the appointment in the first place. Fewer appointments would be made to start with and people would be more inclined to cancel if no longer needed.

Any appointments we received are sent digitally as well as paper so no excuse really. Most phones can receive text messages at minimum.

I agree. We need to start charging for appointments. It’s crazy we don’t

In all the years I’ve been under the hospital I have never had a problem with NHS administration.

Lucky you, my DD has had a lot of specialists involved in her care. She’s had 3 appointments arranged for the same time with three different departments in the same hospital, clashing appointments with the same speciality in two different hospitals, letters not arriving for appointments, the wrong time on letters (appointments made when the clinic is closed). She’s also turned up for appointments when the clinician needed to cancel but didn’t tell us, half a day out of school for no need. At one point it was practically a full time job keeping track and changing appointments when needed.

Some departments seem to manage things really well, others not so much.

They're never going to charge children, OAPs, disabled, nor mental health patients, who together will form that vast majority of appointments. So it's never going to happen. It'd just end up yet another "tax" on workers!

I'm not suggesting a fine for missing appointments, I am suggesting a charge for the appointment in the first place. Fewer appointments would be made to start with and people would be more inclined to cancel if no longer needed.

I have no issue with charging for appointments if it means they’ll manage their appointment system professionally, I’m not prepared to pay for NHS mistakes though so they’d need to evidence they communicated the appointment clearly, with 2 weeks notice and easily accessible cancellation processes.

My OH's oncology and day treatment units NEVER send ANY appointments by text nor app.

I like how the “scandal” of missed appointments is costing the NHS £1.2bn in a system that spends nearly £200bn, like this is the key waste factor 😂

So you're going to charge a cancer sufferer for several appointments every month???

how appointments are sent seems to vary within hosptial as well as between hospital.

my DD is disabled and is seen by three different services within the same hospital. When we moved we updated the address and (foolishly!) assumed it would update the other services. It did not.

none of them have ever sent appointments by text or email, only letter.

And for everyone who lives in a trust that only send appointmenta via letter?

The NHS is getting a lot of stick (rightly) at the moment, so they're just grasping at straws at patient blaming to deflect some of the blame.

Any appointments we received are sent digitally as well as paper so no excuse really. Most phones can receive text messages at minimum.

In my DDs case one team in the department sends appointments by letter followed by a reminder text. The other team, in the same specialism in the same hospital only send letters, which have never yet arrived before the appointment date. Guess which one we’ve had multiple “missed appointments” with.

It’s the system that’s the problem. Summoning people to attends an appointment on some date in the future that suits the hospital / doctor / consultant is just mind blowingly inefficient. Sending the appointment (by post in many cases) and at short notice compounds the problem. And to round it off, make it impossibly hard to contact them to change the appointment, and then still blame the patient when they can’t attend. The system starts from a false premise which assumes that the patient isn’t working, has no child or other caring responsibilities and can get to the hospital on the date / time commanded.

As a mark of how broken and non-patient focussed the system is my late husband, who attended hospital 3 times a week for dialysis on fixed days and at fixed times for the best part of 10 years would, without fail, be sent appointments by the renal, diabetic and surgery teams for times that clashed with dialysis. All fixed by a phone call or walk along the corridor, but the response was often ‘oh, can you move dialysis’ or, ‘yes, I know you’re in here Mondays Wednesdays and Fridays (for 4/5 hours) but could you come in on Thursday to see dr xxx’.

So even if you have managed to find a part time job that fits in round dialysis they then expect you to regularly have time off on your non hospital days for other appointments, even though there are still 4 or 5 hours on dialysis days when these things could be slotted in. And we wonder why so many people end up giving up and just end up being ‘signed off’ on benefits.

Dont' yell at me, please, genuine question.
I'm not saying it's ok to be lazy about attending appointments.

When an appointment is missed I believe that staff very rarely use the time to play candy crush or do their home shopping or gossip about MAFS (etc, & other not work things). I reckon they use actually use the unexpected time on shift to catch up on online training, complete paperwork, chase up patient referrals, talk practice decisions, organise the cupboards. All core duties that would keep the staff at work for lots of extra hours over an already very long full intense day, otherwise. So this time missed could be "breathing space to get on with many aspects of the job" not 100% loss of productive expert HCP time.... which is probably how the £165 figure was calculated.

Is it really "wasted" time that costs £165 per missed appointment?