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 don't think hospital appointments should have a charge, only GP appointments made by the individual. Take the fee at the time the appointment is made.

When you've got a clinic with more patients than it can really cope with it can be really hard fitting everyone in appropriately. Missed appointments are wasted time in that regard and to be fair so are last minute cancellations without enough time to fill the slot.

There is absolutely an issue with some people just not turning up. 100%.

But, as has so accurately been pointed out on this thread, there is also an astonishing amount of inefficiency in the system that creates this problem.

There was a terrifying article in the FT a few months back about a young man with, I believe, epilepsy, who couldn't get his meds over a weekend due to a cock up and who died as a result. But reading the article, it was so clear that if the system had worked in the first place, never mind if he'd been able to access help when he asked for it, the whole problem would have been averted, he'd be alive AND hours of NHS time would not have been wasted.

The other thing I feel is an issue is that I think sometimes people skip appointments because of poor experiences. I have only knowingly skipped ONE appointment ever. It was a fertility appointment. I had had the first one - having been on a waiting list for nearly a year. At that appointment, I had been treated dismissively. More upsettingly, the woman had kept the door open and was lecturing me about the importance of not having sex in te two weeks prior to my next appointment while random people were walking past. So when I discovered I was pregnany and didn't need the additional test, I didn't turn up and I didn't call them. I still feel guilty about it, but they made me feel so small and so miserable in that appointment I couldn't bring myself to call and put myself through the long process of trying to speak to someone who would probably be equally dismissive.

As a slight aside, I’m not sure about cost. The NHS, like all public sector is to some extent about job creation and redistribution of wealth. A lean NHS would lead to job loss, and all the impacts that has on other parts of the economy. This is why you can’t run the public sector exactly like the private sector and why Elon is making a hash of it

edited as I wasn’t clear - that £1.2bn includes the cost of jobs that would go if no appointments were missed

I’ve just recalled an incident from a few weeks ago. I’d taken my mum out for lunch and her GP surgery rang her when we were driving back. They were trying to give her an appointment time and date over the phone, despite mum saying several times we were travelling so were unable to write the details down.

I called the surgery as soon as possible to clarify and the receptionist said they’d already told mum the details and could she not remember them. Mum is 81 years old with advanced Parkinson’s disease so no, she couldn’t remember.

My elderly dmum has had several appts I have taken her to, only to be told that they have been cancelled. I have to take a day off work each time.
It's impossible. I now pay an agency £100 a time to take her.

Yup, that's exactly what happens with OH and his cancer-related appointments. No joined up thinking nor cohesion between different aspects of his treatment. His blood tests MUST be x days before treatment starts - no earlier, no later, as instructed by the oncologist consultant. Yet every sodding month, he has to explain to the receptionist/appointments clerk that yes it MUST be on Monday 20th, not Friday 17th nor Tuesday 21st, because his first Chemo session that month is the Thursday. You'd think he was unique the way the staff make out that he's the unreasonable one!

Once when we went to his monthly oncologist consultation together, we went to reception with a list of dates to make all his appointments for the following month, including 3 blood tests, infusions, chemo drug issuing, etc. OH has it all laid out on a spreadsheet/calendar as he knows the order of things and timescales (he's been doing this 7 years now!). The receptionist was having none of it. Apparently, no blood test appointments available on x date, no infusion appointments on y date, making a right meal of it, and being generally stroppy and obnoxious. Anyway, the consultant called us through, so we explained to him about how the receptionist wasn't letting us make the routine monthly appointments - he said he'd "sort it" and we had the usual consultation. At the end, he took the sheet of paper from OH and walked with us through to reception and TOLD the receptionist to make the appointments as per the sheet of paper - she was all friendly and helpful in front of him, but as soon as he went back to his office, she was the stroppy mare from hell - lots of eye rolling and sighing, but she made the appointments we wanted, on the days we wanted them. She was just being awkward!

Then they would have to actually make the appointment at a time it suits the patient rather than just send out a letter for a specialist appointment on a random date which can be miles away (and cancelled on short notice by the hospital).

I’ve lived in a country with only private healthcare and tbh it was much better to pay but actually be able to get an appointment at a time I could make. The NHS would save a fortune if it was better managed (and ironically I think it needs less managers).

There are things that could be done to avoid wasting appointments.
Inform the patient in a timely fashion that the appointment exists.
Make the appointment for the correct clinic. Even if the patient turns up, it is still a wasted appointment.
If blood test results are required to make the appointment worthwhile, send the patient a blood test request form in time for them to have the blood taken. If that doesn't happen, that is a wasted appointment.
Don't constantly cancel and rebook appointments in quick succession. After the 5th or 6th time, everyone is confused.
All of these have happened to me more times than I can remember.
I know lots of people who have had the same experience.
It is frequently impossible to speak to anyone if you need to cancel an appointment, or if you do cancel, the message doesn't get to the clinic and is then recorded as a DNA.

No.

(mostly)

clinic times is heavily over booked. I have a couple of friends who are hospital doctors and clinics always over run. It’s rare that clinics run to time in any case so mostly the doctor heaves a sigh of relief, notes that they are now 30 mins late instead of 45 and sees the next patient.

the exception is stuff like MRI or other stuff where machinery or similar is needed and they don’t actually over book.

even then there’s probably someone from a and e or in the hospital that needs one and gets slotted in.

Er, yes, that's why I said (in the post you quoted) that I was talking specifically about GP appointments made by the individual.

Fair enough- I should have read it properly!

I think it’s even an issue for gps appointments tho - it’s very difficult to get one at all so you need to just take whatever they offer and take time off work, etc. if we were expected to pay we would want them quicker and at a reasonably convenient time

It didn't help when they phoned my mum, who has alzheimers, to make an appointment for a test and didn't confirm by text or letter. Mum can't remember anything for 5 minutes and doesn't realise she needs to tell us to get her there. We were moaning about the wait time until they sent a letter saying they were taking her off the list because she'd missed 3 appointments. DB has access to her NHS app and his mobile and email address are on her records.

Of course people miss appointments due to MH issues.
I’ve missed an appointment due to very poor MH, I’m not proud of it and it wasn’t intentional but I was really ill.
Two of my teen DC have needed to attend annual outpatient clinics from being toddlers, they've missed way more than my one appointment due to administrative errors.
I’ve had letters telling me we’ve missed an appointment and the letter telling me about the appointment on the same day.
We moved 5 years ago, I told the receptionist about the change of address in person at the clinics. Every single appointment since then has been sent either to our old address for one DC or a neighbour on number down from us for the other DC. I’ve been assured repeatedly on the phone and in person that the issue is sorted but it keeps happening. My previous home has been sold again so I’ll no longer get mail passed on from that address.
We’ve had appointments made for 2034 then a letter telling us we didn’t attend.
We’ve turned up to appointments only to find the letter has given the wrong month or day so we’ve missed it.

Just remembered we once travelled over an hour to see a specialist consultant in a specialist hospital in a different county. It was for a Wednesday at 9am. We were on time after a very early start, and waited, and waited, in the full waiting room - everyone had been given the 9am appointment slot! By about 11, the room was thinning out so OH went to reception to ask how much longer but was curtly told to just sit and wait his turn. By 12 very few people left, and the receptionist did the same when he went to ask. By 1, everyone had gone, including the receptionist, and we were the only ones left. At 2, the waiting room filled up again, and OH went down the corridor to find one of the staff taking patients through to the consulting rooms - only to be told the consultant we were booked in to see never works Wednesdays! So we had a full wasted day due to NHS incompetence.

I do agree with you. I’m not currently in the UK and have to pay for health insurance. I think ‘no shows’ would definitely improve if people had to pay for an appointment, or they wouldn’t go to the doctors when a pharmacist could help. (I don’t think we should get rid of the NHS, but I think lots take it for granted)

The NHS would have to offer a massively improved service if they want to charge for appointments. I.e. accessible to actually make and change an appointment, choice of appointment times/dates, the appointment actually going ahead on time, etc.

My partner is driven demented by the fact that they never answer the phone at the hospital departments. If they don't have enough staff to answer calls then why not put an answerphone on so that people can cancel appointments at the very least.

Very true!!!! Has happened to me.

Once you've updated your address with the GP it will update on the spine so all hospitals will know. If you just update with the hospital but not the GP it will revert to your old address

Halfway down this thread Post at 24/1/2025 at 11.14
https://www.mumsnet.com/talk/am_i_being_unreasonable/5259390-housing-association-saying-im-unreasonable-i-dont-think-i-am?page=10

I queried a breast screening DNA on my medical record. I didn’t make an appointment or receive any correspondence asking me to make an appointment. My GP just shrugged and said it was an admin issue. So my DNA is added to the total of missed appointments and is permanently on my medical history.

There’s a number of problems with charging for appointments.

the most obvious is that many of the people who use a lot of appointments are not in a position to pay. Doctors need to monitor people who are having chemo and people who have brain tumors etc etc. a lot of the people who are seriously ill don’t have an income either because they are retired or because they are out of work either temporarily or permanently due to their illness.

macmillan run regular campaigns encouraging people with cancer to speak to them to get advice on how to claim benefits etc because many people with cancer do lose their job because they are so ill and can’t work.

a friend of mine is having chemo at our GPs(we are pretty rural) and she has chemo every Friday and bloods etc in between. 15 quid each time adds up pretty quickly.

and then there’s the issue that (a bit like with student fees) if people are paying they expect a minimum level of service. These days healthcare wise you pay for dentist, physio and lots of other stuff that once would have been free.

but if you are paying it creates a whole new set of expectations. Firstly that they will see you (I’ve paid for this appointment and I want to see the GP) and also that you can cancel/have it at a convenient time etc.

many workplaces without private medical are now buying into new private gp services. I worked in a school until three years ago and they had a deal that for twenty quid a month you could access a private GP service by video call. Only 240 a year but it meant you could book an virtual appointment pretty much anytime (they were open six days a week 7am-7pm) and they’d happily prescribe for uti’s, chest infections etc.

you can’t get in to see a GP these days for something like that, and it doesn’t take many 15 quids before people start thinking that 240 a year is very good value.

I'd be insisting that they "correct" the records under the data processing legislation. I've had to do it a couple of times when the comments on a GP appointment have been wrong and didn't reflect the true conversation. They don't like it when you challenge them, but it's important that formal records are actually correct!

Good Then i can expect to be seen ON TIME