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

Then people would just clog up A&E. And then you're penalising people like me with long term health conditions that need to be monitored and medication changed regularly.

I, like others, have had appointments cancelled. I received a call to ask if I was still attending. Said yes and received a text 2 days later reminding me of my appointment. It has been cancelled the day before and a letter sent out which I'd received the day after the appointment

I'm missing the relevance?

I suppose I phrased my point poorly but I'm asking how much money is lost to the entire economy as a result of the waiting hours sunk into waiting for appointments for which they arrived on time. It's a hugely inefficient system and I expect money is lost all over the place.

Remember the queue for NHS dentist in Bristol? https://www.bbc.co.uk/news/articles/c36021k78keo

On the first day alone 9 people did not turn up for their appointment. 9 people who had queued up and made an appointment in person , did not contact , just failed to turn up. 40% of all NHS new dental appointments are failed . The worst culprits are males aged 18 to 30 and those who claim free dental treatment.

It denies others appointments and as the surgery does not get paid at all for missed appointments is another driver for practices to go private.

From personal experience I can tell you I have had old ladies coming in through deep snow/icy conditions at risk of falls who say “didn’t want to let you down”, and serial offenders who have no excuse and then become abusive when told we wouldn’t see them again.

This is not a failure of communications, these people made appointments themselves , and it is interesting to note that since NHS practices can no longer charge for missed appointments ts the rate of failed appointments has sky rocketed.

They need a system where you can reschedule an appointment without having to phone a random number that nobody ever picks up. Think how much time could be saved if people could just change their appointments online.

I once missed an appointment because I turned up to the wrong hospital (hear me out) ... there are three hospitals within 20 miles of each other near me with ridiculously similar names. Think Queen Elizabeth vs Royal Elizabeth vs Saint Elizabeth. I was so embarrassed and apologised profusely, the lady just said oh don't worry it happens every single day. Would probably save a hell of a lot of time if each hospital could just be named after it's location rather than being given a stupid frilly long name.

Yes. My OH is self employed and has worked continuously throughout 7 years of cancer treatment, chemotherapy and other infusions, etc. He'd have been able to work a lot more if it weren't for the NHS messing up appointments and being generally inflexible for no obvious reason. Such as wanting him in for an appointment mid morning and then another appointment mid afternoon, so rendering him unable to work for that entire day. And making appointments and cancelling at short notice meaning he has to cancel pre-planned work and end up with the original appointment day (cancelled) with no work to do. He'd easily be able to say "sod it" and go on disability benefits and give up working, but he doesn't want to. He wants to carry on working as long as possible to keep some kind of normal life, but he's thwarted by the NHS. He can even lose an entire day just phoning the different depts to make his regular monthly appointments and correct their appointment foul ups. Multiple that kind of experience by millions of patients and it's easy to see how it costs the broader economy billions in lost productivity and lost business.

Someone who works in the housing sector on that thread is saying a visit from an HA contractor to do things like a gas safety check should take precedence over a chemo appointment.

You know that wasn't me though, right?

Makes sense to give your key to a neighbour or your ha in that situation though and get both done. 🤷🏼‍♀️

Similar to others above, I am under oncology. I’ve missed 2 appointments when I have been admitted and asked the ward to cancel the appointments which they said they would. Of course then I get called asking where I am..

what astounds me is oncology aren’t able to look me up in the system and see what appointments they have already given me, so different bits (chemo, nuclear medicine, oncologist etc) all try and give me appointments when another team have already got me booked in. Mind blowingly inefficient and frustrating especially when you are ill and desperate to attend appointments.

Nail on the head. Unless you've experienced it, it's hard to believe just how shambolic the whole NHS is. In my OH's case, it's different treatments under the same oncologist but in different departments of the same hospital. There's just no communication between them at all. They won't even do "joint" blood tests for more than one dept - they insist he has to have a blood test in the day treatment unit ahead of infusions in that unit, and blood tests in the oncology dept for chemotherapy a few days later in the oncology dept. The amount of wasted appointments is insane - not with people missing them, but different appointments for things that could be done at the same time in one appointment, especially something so simple as a blood test! Far too many little "fieffdoms" without proper oversight nor management.

I know it wasnt you It just illustrates that its always the patients fault or tenants fault. Give key to a neighbour? My tenancy agreement says its got to be the tenant. And also if the HA wanted that (which they dont) dont fill flats with druggies.

cough cough

https://www.mumsnet.com/talk/_chat/5319581-the-royal-mail-is-dying-on-its-arse?page=1

Twice I changed appointments for DD then got asked why we didn't turn up for the original appointment. One was a GP appointment changed over the phone. They actually rang me on the day of the original appointment to ask where we were and I explained we'd rebooked - but clearly they'd failed to delete the original date/time. The 2nd was a consultant appointment at the hospital. I was actually at the hospital and went to the receptionist to change it. She even rang the consultant's secretary whilst I was there as she needed to override/overbook the clinic to get the new appointment in. It was only when we went to the new appointment that the consultant asked why we hadn't attended on x date. There was presumably some sort of 'no show' marker on the file. When I explained that I'd cancelled that appointment, in person at the desk, they rolled their eyes and said "I didn't think it was like you to not turn up".
So I think inefficiency within the booking offices coupled with the archaic system of sending letters by post which never arrive/arrive after the event, is responsible for some of it. Plus you can't get through on the phone to change appointments, so no doubt people give up.

There's an irony that successive government's have suggested that the best way to reduce NHS costs is to eliminate management and admin staff. This might be possible if decent systems were in place. But until then, enough admin staff, overseen by effective management really is necessary to make the most of clinical staff time.

My mum had a hospital appointment she couldn’t attend because she was dead. I had a reminder sent to my phone. The department didn’t ever answer their phone. I rang and rang and eventually had to physically attend and tell the receptionist to cancel it.

I was handed my cancellation letter at check in.
I missed another appointment because no one told me about it at all. They just sent me a "you're off the list and can't see a neurologist without being referred again by a GP"
I assume (perhaps wrongly) that I am fine else they wouldn't do that.

Postal appointments are too slow and cannot be relied on as well as strikes and non delivery.
In France people make their medical appointments on line, so people can choose what time is convient for them and the doctor’s time. This is then confirmed by a text message and again a week before the appointment as a reminder, giving the chance to cancel and rebook another appointment. A final text is sent the two working days before. If people cannot cancel 24/48 hours before they are charged a standing fee, if they do not keep the appointment, if there is not a good excuse.

This type of freedom, to chose an online appointment and text reminders on mobiles plus charges should stop non shows, therefore a saving for the NHS as well as more available earlier appointments for the public.

the NHS/ Royal Mail have no introduced “NHS class” separate from 1st/ 2nd which is meant to prioritise appointment letters. Obviously doesn’t help if the letters don’t get into the postal system in time though

My friend missed hers because she died literally on the morning of the appointment

A charge for missed appointments is very reasonable, but only if appointments are informed about well in advance, with a phone number to contact if you need to change the time or cancel. This is how it works in my country, get a letter well in advance or make the next appointment while you're there or call and arrange an appointment yourself, most of the time get text message reminders confirming the appointment and reminding the day before and/or a couple of hours before. With my occupational healthcare I can even check in at the clinic via text, just replying to the message they automatically send before the appointment, then they know I'm there and I get a reply telling me which room to wait by. But if you miss an appointment without informing them (24 notice for any reason, less notice for a good reason like accident or illness) its a 50 or so euro fine which is steep enough to put most people off missing their appointment. I've had to miss a few for various reasons but always cancelled in time except when I was in hospital but when I explained why I missed it the fine was waived. And there's been times I've been called in last minute for a dentist appointment because someone has called to cancel theirs so they were able to offer me an appointment even sooner than my booked one so I've enjoyed the benefits of people having to inform when they can't attend rather than just not attending.

There's also fees for all appointments except children's clinic and midwife appointments, and everyone is charged including OAP, disabled, those with MH issues (but there's a yearly limit so for those with chronic health issues that require lots of doctor/hospital appointments once they hit their limit the rest are free and people on income support get all medical bills covered except, I expect, missed appointment fines)

With NHS appointments there's so much potential for miscommunication and fuck up that I think it would be a near impossible to work out which patients "deserve" to be fined.

IMO, it’s got worse since they started contracting out the letters for appointments. Our local hospital generally used to send out appointment letters 3 months in advance. Now, the letters come from the other side of the country - usually giving about 48 hours notice! This is especially no good, when you get a letter on Friday for an appointment on Sunday morning and you’ve made plans to go away!

Exactly!!

NHS admin is chaotic. A BiL with cancer had an appt letter sent to an address he’d left 17 years previously- current owners forwarded it. NHS had his proper address, several other appt letters had been sent to the right one.

Why on earth they don’t use email instead…
And dh was sent to the wrong centre for a minor day surgery procedure. There was no time for him to get to the correct one, so that was another appt wasted.

And I don’t know whether it still happens, but I used to hear of so many cases of appt letters being sent only to people with dementia - despite relatives pointing out that they’ll never remember, and will most likely lose or destroy the letter.
If relatives didn’t have PofA, it was not allowed for them to be informed too, because of ‘patient confidentiality’. FFS.

Yes, brilliant thought isn't it?

🙄🙄

🤗😘 to you & your DH.

Dh had a hospital appt recently but couldn't attend as he had surgery that day. He rang up to reschedule and was told they couldn't do that so was told just not to attend and they'd send out another appt but if he couldn't make that one he would be taken off the list and his details would be sent back to his GP.

So in theory they could have a whole day of no one attending appts just because they aren't able to reschedule.

FFS 🙄