To think this hospital policy puts children at risk

[RoseWay]

I'm normally great at attending hospital appointments for ds but I missed one, I managed to miss a letter with a date due to moving and it being sent in the two week window when I forgot to update my address with the GP/ hospital. My fault and I apologised, I feel very embarrassed for time wasting but being pregnant and stressed I'm not on the ball as usual. Obviously I've learnt from this and feel stupid already without anyone else's help.

The hospital responded by simply discharging him for missing the appointment, which I can see the logic in I guess. However I only found out a few months on when I rung to find out why I'd had no appointment for ages. The bit that concerns me is my GP/ HV were not informed of non-attendence. Were I a negligant mother and denying my son medical access he could potentially become very ill, resulting in developmental problems or worse, as is the case for children that attend this outpatient clinic. I'd expect my HV or GP to be bloody supcious and checking up in cases such as this. A child could become seriously ill because of this policy of discharging children without any checks being made.

I can easily rectify the issue in my son's case by the GP re-referring ds but it chills me to think what could happen if an abusive parent failed to care properly for a child. What's even worse is I have already been through quite a bit of HV input as DS failed to thrive as a baby and there were obviously suspisions, so had there been a check this may have flagged? (Obviously I wasn't neglecting him and the diagnosis resolved/ explained it, I think they thought I had pnd and wasn't coping. I was just very tired from no sleep and an ill/ screaming child)

It's the same here, it's stupid. Ds's physio appointment was cancelled as the physio had been involved in a riding accident. I waited for a new appointment but eventually called them to see where it was. Turns out they had discharged him without bothering to contact me. I'm now waiting for a new appointment with a new health authority as we moved on the day which he should have had his physio assessment and they wouldn't see him. This has been going on for about 4 years now, and has an appointment with a paediatrician in September so we get to start all over again. Oh, joy!

if every health visitor followed up every non attendance for children on their caseload, do you really think they would have time for anything else? How about the parental responsibility? Was it a life/death appointment (I'm guessing not as else you would have remembered). When you go back to the GP, they will probably have a letter on their system saying you did not attend, but really don't have the time/resources to follow up every parent who does not attend appointments - else they would do nothing else.

Hospitals discharge as they believe that somebody who didn't attend an appointment without even phoning to cancel, or re arrange doesn't really warrant another appointment.

So yes in short, YABU. This is not a nanny state - remember your appointments, and if you can't then at least have the courtesy to phone. And missed appointments mean that somebody who really needs to see a healthcare professional has missed out.

This is something that drives teachers nuts. We raise an issue with parents and the school nurse takes forward the referral. Parents don't turn up to appointment then NHS discharges child due to non- attendance. There seems to be no duty of care.

I can't tell you how many times this has occurred in my career. I get so angry. It's always left to the school and teacher to then 'cope' without the needed support from other professional agencies. This appears to be a non-issue for social workers.

I taught a child who was hospitalised twice for severe asthma. Mum never attended the asthma clinic at GP surgery. The only meds issued were at school in accordance with the school nurse's instructions. Child was the HDU - nearly died.

This makes me soooooo angry. It's an issue that really pushes my buttons. It's not usually as life threatening as above. I've seen non-attendance at SaLT, OT, Physio and CAMHS.

stargirl I hear you. The number of times I have been on the phone and begged the other agency not to let the child suffer because of the parent's non-attendance. I can't believe they don't follow up at least the first missed appointment. Surely it only takes one call from the administrators?

To be honest I would be happy to the child to the appt if it was after school but that then breaches confidentiality. It's such a shame when you know the service that could be of great benefit to a child is denied to them because of parental non- attendance.

stargirl- I'm a teacher dealing with this too, but I'd still be informed when referrals made are missed- so at least someone is aware. I have gone down the childin need route once.

I was surprised as other people on here mention HV contact after A&E visits

The GP will most likely have had a short letter saying that you didn't attend.
Non attendance is really common, in some places 50% of new referrals.

YABU and YANBU.

I completely get your point,but I expect there are far far more appointments missed due to absent minded ness or some trivial thing than there are appointments missed due to neglect.

The NHS has better things to spend its resources on rather than chasing forgetful parents. It wouldnt be a problem for the system to stay the way it is if these services listened to schools, as stargirl says. The children who really need help would still be picked up and identified, and the NHS wouldn't waste time and money on things they shouldn't have to worry about.

A letter should be sent to the GP and HV so it is on record they have been discharged. Doesn't necessarily mean they have to do anything with the information but it should be on record.

mellen, this is a child who has regular (though now only every few months) OP clinic visits. GP wasn't aware, I know as asked him to re-refer.

I work in a school, we receive children at 5. I've met a few over the years as SENCO children with difficulties linked to poor medical attention before age 3 or 4/5. Off the top of my head one child with digestive and developmental problems with allergies being treated with herbal remedies alone and a very restricted diet and a few with various untackled physical needs, e.g. day 1 in nursery not being able to walk or grasp a cup. It's an area with a sadly high level of children in need.

And it is the children who need support most who are let down.

Sorry - this really is my 'ishoo'.

My typing has fallen apart on this thread as I get worked up!

non attendance within NHS is a huge problem that is why they book in 8 patients at 10am and 8 at 10.30 if all 16 turn up they are running an hour late by 12 but on average 25% DNA (do not attend) hence overbooking

I remember being on a training clinic as student for children having day case surgery, we had to witness 8 cases so we had 2-3 sessions booked in the hope that with 24 booked we might see the 8 required, on one session only 1 out of 8 arrived, nothing potentially fatal but if not done ongoing discomfort infections for child etc I was astonished at the time that people did not attend themselves or bring their children to appointment now it does not surprise me

apparently 1 in 8 patients do not turn up for booked surgery. ( this does not include people who cancel even at the last minute)

I think if you had rang the next day directly to hospital saying I am really really sorry but yesterday we moved house i forgot can ytou re-arrange they almost certainly would have done but if you do not call them they assume you are not interested there are far too many DNA to follow them up

In a trial at last practice for 2 months they rang everyone the day before to remind them of appointment as DNA rate was about 8%, this diod cut rate to about 5.5% but it took 1 receptionist about 2-2.5 hours everyday to do this

I am under 3 consultants at the same hospital. I saw one consultant in June, who wrote to one of the other consultants to tell him that the treatment he had given me in April hadn't worked very well. So this Consultant decided he would repeat it.

I arrived home from a weeks holiday on a Thursday afternoon a couple of weeks ago to find the letter saying that I should attend the hospital the day before for the repeat treatment, so I had been given less than a week's notice.

I phoned the hospital and explained what had happened, and said I had an appointment for the 30th Juy. I was told because I had failed to attend they had cancelled that appointment and was in the process of discharging me back to my GP! I was bloody fuming. After talking for ages on the phone to secretary, and me being in tears, they said I could continue to attend the hospital.

I wouldn't mind so much, but since April I have had 7 things(including 2 minor ops )cancelled at the last minute!

part of me is thinking, wake up and smell the coffee, I should expect this after frequently at work referring child after child into the black hole that is child protection.

The other half thinks 'haven't we STILL learnt lessons?'

I think I get worked up because of work...

I fully appreciate how many DNA, but I would have expected children, as when they visit A&E, to be followed up in some way. Or even just certain clinics, e.g. cystic fibrosis or asthma.

Obviously I would have rung had I received the letter, but it went to an old address so I was unaware it had been sent.

Sarahtigh - My dentist sends text message appointment reminders, it's an automated system so doesn't take any receptionist time. I don't know whether it improves attendance (the amount they charge does tend to focus the mind anyway) but I'm surprised more hospitals/health centres don't use a similar system.

Three of our local hospitals send text reminders for appointments. It must be a trust wide thing.

I was discharged from physiotherapy - not for non attendance, but for having the audacity to request to change my appointment time more than twice in 3 months. In all cases I phoned at least 24 hours in advance and the reason I asked to move the appointments was that I couldn't walk far enough to get to the bloody appointment, due to the condition I was receiving the physiotherapy for! Absolutely mindboggling.

Non-attendance is not always the fault of the parent. DD ended up being discharged after we didn't turn up for an appointment we didn't know about.

Problem is the hospital policy that you can't make follow-up appts as you leave previous one, they insist they send you a letter telling when the appt will be.

But we didn't receive a letter for a long time so I called to be told we'd missed a scheduled appt. We'd had no letter at all. I was really cross and we had to go to the fuss of a new referral.

Naoko, that is incredibly frustrating.

I work in the NHS and had to have physio at the hospital where I work - I was told that they are incredibly strict with their appointment policy because nationally, Physiotherapy is one of the most oversubscribed departments in terms of waiting lists. There are so many people waiting for places, that they can't afford to be too forgiving with people who miss or cancel.

Not fair, I know, but just the way it is at the moment

It's actually the second time ds has been discharged the first time we did attend but weren't recorded as doing so on arrival (also meant 2.5 hours in the waiting room until I bypassed the receptionist and found a nurse who told the doctor we were there). Had to send them the notes from the appointment to be believed.

I work in the NHS and am stunned at the number of missed appointments. Personally I think there should be a penalty charge (although God knows how you would administer it, I admit) because for every one of you nice ladies who misses the odd one through a mix-up/brainfart, etc there are loads of idiots who just don't give a flying fuck how much they are costing the rest of us.

The other problem, of course, is that a huge number of patients don't keep the hospital/GP up to date with changes in phone number, address etc.

Our clinic booking in is now done using a self-service terminal, but back in the days when we had receptionists on the desk, they had to check each patients details against what they had on the computer system as they booked in.

The problem was that people (understandably) didn't like having their address and phone number reeled off in front of a queue of people.

They weren't allowed to turn the computer screens around to visually show them, so were reduced to asking "are you still at the same address and have the same telephone number"

Unfortunately most people automatically replied "yes", with their house move and new mobile filed neatly away in the 'done that, now forget about it' bit of their brain.

We have to phone patients all the time to check treatments and it's astonishing how many are impossible to get hold of!

People have no idea how much appointments cost per head. I'm not sure any more.

I know it used to be in the region of £80 per appt, but that was back in 2000. I imagine it's more like £150 now