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

As I said, texts and apps worked with us for banks, utilities, etc. It was the NHS which was a fiasco because they continued sending paper letters which got "hidden" for safekeeping. Texts and apps on her mobile worked really well because she never used it herself, so we'd just turn it on when we visited every day, to check for texts/notifications, etc and dealt with them. Thankfully, she left her mobile alone and never tried to "hide" it as I don't think she knew what it was!

When a patient has carers (such as close family), the organisations need to deal with the carer which is why apps, texts, etc work far better than bits of paper which may or may not get delivered and then may or may not get "hidden". We had no end of trouble with paperwork from utility firms and banks until we got it all moved over to apps, then it was plain sailing because we could remove MIL (with dementia) from the process.

Even though her GP was the one who formally diagnosed dementia and it was all over her notes, as was instructions not to write/phone directly to her, and to contact us instead, the GP surgery continued to phone her and send letters for flu and covid jabs etc.

Paper based systems really don't work for some patients, especially when the NHS itself fails to follow communication instructions. That's why charging for missed appointments would never work - the NHS would never even try to charge a dementia patient for a missed appointment and if they did, they'd waste lots of admin time dealing with complaints and appeals when they've not followed communication instructions!

We are about to go through this with DM She had an x ray request cancelled as the hospital were unable to contact her, This is what she was told in a letter from the hospital Its highly likely she didnt hear the phone

Mine does, I have to be present when any work is done unless it's outside and no access to inside needed.
With a HA that schedules appointments for me, and I sometimes get informed, they are usually less than a month away and I have a job that requires 4 weeks notice for AL, it's been an annual issue. I've asked about having someone else here but it has to be a tenant, unfortunately that's only me.
Thankfully my employer is more cooperative about NHS appointments because they're to do with your health and I have been granted short notice leave for appointments before, but refused for housing things.

With job obligations to meet that have concequences of not doing so, it's a rock and a hard place.

Don't get me wrong I'm grateful for having a home I can afford, but if they're relying on my cooperation to meet their legal requirements then it's probably a good idea I know about the appointment to start with.

I don't doubt there's people who just ignore them, same as there's people who don't show up and don't even try and cancel NHS appointments, but if you're going to organise people's lives for them, it's probably a good idea to keep them in the loop about it so they know when they're required and can cancel/reschedule if they can't keep that appointment - like they have to work.

People don't just make this stuff up for fun, and just because the HAs you've dealt with or worked for don't do it, it's not reasonable to assume they're all the same.

I was all set for an operation tomorrow but the hospital rang this morning and cancelled.

I had a blood test booked for today at a different hospital but same trust.

The woman on the phone told me I needed to cancel the blood test but I spent all bastard morning trying to get through on the phone, and finally had to give up!

The HAs I’ve worked for cover millions of tenants. What you claim is in your tenancy agreement is very far removed from common sense or standard practise as clearly you don’t have to be present for a gas safety check which can be done easily by court order and a locksmith forcing entry- no one could care less whether your there or not, nor is there a logical reason why you would need to be.

are you sure you haven’t misunderstood a standard clause stating you must allow access?

This is wishful thinking! I still get calls and telephone appointments coming through to my mobile for my 23 year old DD, from at least 2 hospitals. She has changed her number at the GP, via phone to the hospital, in person and through the online portals. The NHS systems are a bit of a mess!

This here is the exact problem with the NHS.

It is incapable of joined up thinking and understanding how smaller things become big issues that could be solved by an overarching approach.

Instead it ties itself in knots trying to “save” money. Except it doesn’t save money at all and it is usually the patient to at suffers.

Instead of wondering why it costs so much in missed appointments it should be investing in a digital system across all trusts where all appointments can be seen from GP to consultant, and can be booked/rebooked and cancelled by the patient. Every single hospital.

It would cost money upfront (which is why they won’t do it) but it would solve so so many problems.

Contracting our letter for fucks sake.

To be honest if they weren’t so incompetent perhaps people would give a shit about missed appointments.

The only I missed - my doctors surgery managed to write my prescription incorrectly when I change from a liquid to a pill- different to the previous ones - by HALF ! I phoned up multiple times to tell them what they had done.

I put in a request for a new “half” as it obviously going to run out. They then were surprised despite the fact I had told them and asked that they change the repeat prescription.

They refused to issue the next lot of repeat prescription as it was “too early” and wanted me to make an appointment so someone could “go through it with me” as though it was me that was wrong.

The receptionist was snotty with me and tried to explain it like I was five and didn’t understand the mg of the drug I had been on for a decade. I made the appointment for the following week but also put in a complaint.

In the interim someone with a brain read my complaint, passed it to the lead GP who realised they had fucked up and changed back it to what it should have been and phoned me to tell me - I could then see it on the app and requested it.

By the time I had gone through all of this and collected my medicine I had forgotten about the appointment and quite frankly couldn’t give a flying fuck anyway.

My dad has been discharged from one of his consultants for cancelling ‘three’ appointments (with notice). One he has a cold and was told not to attend, so ‘rearranged’, but you can’t actually rearrange, they just send you a new one, that one he couldn’t attend because he was on holiday, so when he phoned to tell them that as soon as the letter arrived and they discharged him. Yes we are confused as to how that adds up to three as well.

His GP will now have to re-refer him because it’s a condition that doesn’t just go away. Or maybe in the meantime the condition will go uncontrolled and he’ll end up in A&E instead.

Absolute waste of resources.

My DD got an appointment letter today sent a week ago. From date on letter only had today and tomorrow to book her appointment or they would take her off list!
I have cancelled three appointments for my DP’s because they were both actually in hospital.

One my DM breast screening the person answering phone was rude. I told them she was unconscious on a ward, with a gallbladder infection.
Told them we could see the bus in carpark from her window and if they wanted to take her they could. Bastards

I missed a couple last year down to sheer miscommunication between two doctors I was seeing. One told me there was no point in me coming in for another appointment but it failed to cancel on their system and the other Doctor wondered where I was ...

I do wonder how many missed appointments are due to things like this ...

I have just remembered. For a while I was under gynecology.

I had an appointment for a procedure and it said - on the letter - to cancel and be sent a new one if I would have period on those dates

As it happened I would have had. So I called and got told my someone else in a rude tone that if I did this more than twice more I would be discharged and sent back the my GP.

Given I wasn’t able to schedule the appointment for a date I knew I wouldn’t this was a real possibility.

I did point this out - to which she suddenly seemed embarrassed as though she’d never heard such an intimate reason before and it was TMI ( it’s a medical appt fgs) but I really should have asked WTF women in this fairly common situation should do instead.

A few years ago we took our son for an afternoon appointment only to be told we’d missed it as it was actually scheduled for 10am. Obviously we had the appointment letter with us showing the time we’d been given. It was looked into and we should’ve been notified of it being rescheduled for earlier in the day.

The following day a letter sent 2nd Class on the day before the appointment arrived, advising of the time change.

Our other son is a teacher and since Covid has been having 6 monthly telephone appointments which can be anytime between 2pm and 5pm, he has asked for it to be noted that he’s called after 4pm and apparently it is but he usually misses the call because he’ll be contacted before 4pm while he’s teaching. On one occasion the doctor called me to say she couldn’t contact him but would I be able to take the appointment on his behalf! It’s nothing too personal, haematology due to a hereditary blood condition, but even so my answer was quite rightly no!

The greater issue in my opinion is the lack of respect for patient time and the concomitant impact on the economy.

Example 1:
Rheumatology appointment at 11am
(Bear in mind, I have to arrive at 10am to be sure of getting a parking space to be on time)
On arrival - 30 minute delay
55 minutes after arrival - increased to 60 minute delay
75 minutes after arrival - increased to 90 minutes.

I could not stay as I had a 2pm meeting and I am not late for external stakeholders because it is very very rude.

There was neither explanation nor apology for the delay. Two and a half hours of my time was wasted and I had 4.5 hours of work to catch up on. When I explained I had to leave, and questioned the 30 minute, 60 minute and 90 minute business I got the privilege of the NHS eyeroll. However they did give me an appointment for 9am a fortnight later.

Example 2:
Mother had a TAVI heart procedure arranged for mid March 2024; cancelled 48 hours beforehand because admin got the lists mixed up. It was at a London hospital 80 miles from her home. Train tickets and an hotel had been booked for arrival the night before. She was 87.

It was rearranged for late April. They came up by train, checked I to an hotel, got to the hospital at 8am the following morning. Fortunately I arrived at 8.15am in time to meet the two surgeons who were debating with her whether to cancel due to lack of beds. I interjected with the fact she had been cancelled once, causing much distress and two elderly people had travelled from the coast. After a hard Paddington stare, she was put back on the list. I suspect that wouldn't have happened if I hadn't been there and appeared "switched on".

I cannot begin to explain the unhelpfulness of GP's, local hospital, chasing referrals, etc. One super employee told mother that if she couldn't book a blood test on-line, she'd have to find someone who could because they didn't do it on the phone.

Example 3:
Step had his knee replacement op scheduled for two days after the failed March procedure. He cancelled because mother's heart trumped it. And explained.

Step's knee was rescheduled for two days before mother's April procedure.

He was put back to the bottom of the waiting list and is still waiting. I fail to see why their rules should be punitively applied when things are cancelled due to them messing about the couple.

Personally, I think no shows should be fined but that would only work if the patient could render bills for expenses incurred when the NHS keeps them waiting or cancels at the last minute.

I could go on and dread to think of the impact on GDP.

Healthcare professionals persistently complain the public doesn't respect them enough. Respect is mutual.

So basically you are now admitting that the tenant not having to be there actually also includes a court order and forced entry too. So you were being disingenuous

Yes I'm sure, because I'm not an idiot?! I know the difference, despite living in SH.

It happens every year, I've lived here 8 and for the first 2 when I got the appointment* I asked if my mum could be here because I couldn't.

"No, it has to be a tenant"

Had to be rescheduled.

What's to misunderstand?

(*Well that was after being threatened with a locksmith and forced entry because I'd 'refused' entry because I wasn't told about the first appointment and of course I wasn't in, so I was seen as obstructive. That at least has been improved as I now get a text. Much easier to be in for/reschedule an appointment you know you have)

And yes, there's no logical reason for it, that's why it's so frustrating, but I don't make the rules, they do, I just have to abide by them if I want to live here. They told me it was because the tenant needed to sign for the job being done.

But seemingly you're determined that it doesn't happen, you're well used to being told you're lying or making stuff up when you live in SH, the stereotype of the type of people who live in SH and how they're perceived is alive and kicking.

I recall someone on another thread saying her husband was off work because he needed leg surgery - he couldn’t walk. The waiting list was over a year long.

He worked for the NHS - I think in a clinical role too.

Their own bad service affects them too.

I’ve told this one before too - but similar to you I once had to leave after hours of delay as I would have missed my shift. If I had missed my shift there would have been no food the following week.

I did inform them and they seemed gobsmacked that anyone could deem anything more important than waiting for them.

I had walked there - 2 miles and had to walk 2 miles back because I didn’t have £1.50 for the bus. Unfortunately yes eating was a more pressing need and yes money was that tight.

I think this is a big issue. We have missed 2 and would never imagine just not showing up. I don't know how they are recorded, but very much hope it is clear in the stats that we did not just dna, we couldn't.

I’m generally there in good time as have good post.
On running late I have a couple of family members who are doctors

• yes sometimes dr fault running late
• difficult news for a patient or one needing an interpreter takes a lot longer, all appointments had to be same length (would not have been a problem for other relative in a different Trust which had more control for consultants on appointments length)
• covering the wards due to lack of staff so called to emergency

@Maverickess Busy this weekend here Got to empty the hall cupboard so my HA (who threatened me with my tenancy agreement after my dad died despite agreeing with me initially to cancel the job due to bereavement ) so my fuse box can be changed so if there is a crisis i cant do anything about it. Contractor in my home on Monday and DH has to go out so i cant leave. Electric will be off for a few hours so i need to check that nothing goes wrong after job is completed
Best bit is the electrical check was January LAST year and it was them who dragged their heels till last autumn. Dad died last October
The State cant have me in two places at once If they want to treat me like this because i rent then i am unavailable for family care

All perfectly understandable but what is wrong with having the courtesy to.provide the patient with an explanation and an apology. When they are heavy handed about me arriving on time, I reserve the right to know why they are not on time for me.

First post nails it!

@RosesAndHellebores I keep getting calls from a private number Im sure its to do with my elderly DMS care but i cant return the call. They expect us to walk around all day with our phones literally glued to our palm

A nominal charge is great.

And for every minute past your appointment time you have to wait, you get a pound refunded.

No one would ever have to pay anything!

Talking to a friend this morning. She got home yesterday afternoon to discover a letter telling her she had an appointment at 10 yesterday morning. Her post doesn't come until lunchtime so even if she'd been at home it wouldn't have helped.