to think that no wonder the NHS A&E depts waiting time is bad, there are so many timewasters.

[CalicoBlue]

I just spent the afternoon (3 hours) in Urgent Care/A&E with DS. I have not been to A&E in over 12 years and was really surprised at all the reasons people were there for. Granted if it had not been the weekend I would have gone to my GP, but my son's condition meant he needed to be seen today.

We were sat very close to the welcome window, so I heard every new person come in. There were so many people there who should not have been. The nurse kept asking people if they had seen their GP, so many said no.

One girl said that she had been there last week had been given antibiotics for a water infection and it had not gone so she wanted to see the doctor again, the nurse said that she should have made an appointment for her doctor and that urgent care was not to come to instead of the GP. There were at least two that had lost prescriptions given by their GP so wanted UC to replace them and would not take no for an answer. It went on an on, another person came in with his father who had an ongoing leg problem, the nurse tried to explain that he needed to see his GP, but he did not have one as he was on holiday and wanted to get his leg sorted before he went home again, they did tell him that they would not see him and he would not get the operation he said he wanted on the NHS.

I estimated that at least one third of the people coming there could have been seen by their GP. There were lots who did need to be seen, and lots of sick kids, but they had to wait so long. I felt quite guilty for being and taking up the doctors time.

That would be difficult to administer, although on first sight attractive. There is a notice in my GP surgery about the amount of appointments missed. As you say, it's scandalous and hardly anyone has an excuse. I was roundly told off via a very sniffy phone message and follow-up letter when I failed to make an antenatal appointment. Not much coordination between GP surgery and hospital because I was at that very point giving birth a month early.

I noticed in my local hospital when I was taking ds for an appointment that there is an "Older Persons Assessment Unit" which is a good idea. It seems 90% of the people in the doctor's or A&E or in hospital at all are elderly. Mil used to go to hospital with the slightest ailment.

It would be unfair to fine someone who is in the middle of a pcychotic episode.
I think that exceptions would have to be made for the elderly who might have memory issues/ dementia or those with learning difficulties or some types of mental illness.

I would like GPs and hospitals to have the freedom to issue fines in the same way that head teachers can issue fines for non attendence/ lateness. My GP surgery strikes anyone who misses three appointments off their list. I feel that this is worse than a fine as it could leave someone without access to health care.

It is really not surprising that the elderly need a lot of GP appointments or A and E appointments. They aren't abusing the system. Lots of people in the eighties have multiple unpleasent symptoms because of various bits of their bodies wearing out. They are often close to death. Lots of elderly people I know don't go to the GP enough and suffer unnecessarily.

Has there been research on why so many GP appointments are missed? Medical professionals I know simply overbook, so although appointments are missed, all of their time is still filled with seeing patients.

mariamin yes, my OH (consultant) books all his NHS clinic patients at the same time so they all have to wait. Apparently patients' time is worthless.

Charging for missed appointments is all well and good but I think they need to improve hospital admin first. I have been bollocked for a "no show" when I had no idea an appointment was booked and only found out when the consultant's secretary eventually deigned to answer her phone! It seems an inordinately large number of NHS letters go missing. Surely email and SMS are more appropriate these days anyway?

The majority of people who miss GP appointments are just god damn lazy. It is not their thought, and its not the thought of hospital admin either. With GPs you phone up and make the appointment. In my area hospitals usually get the patient to phone up and make the appointment. In circumstances where patients are sent an appointment time, maybe we should ask the patients to email/ phone/ website that they can make the appointment by a certain date or to change an appointment.

The NHS in my area has emails and SMS to remind people of appointments and idiots still miss the appointments. Missing an appointment shows a total lack of respect for health professionals. I think that we don't value health professionals' time because we don't have to pay up front. A small fine would focus people's minds. Hospital admin would have less to do because they would not have to send out new appointments to non attendees. The revenue from fines could be ploughed back into the NHS.

Not all health professionals overbook. A lot depends on the nature and length of the appointment. Certainly SLT or audilogy do not over book. Hospital consultants are slightly different in that the appointments are often quite short.

ReallyTired - How do you know they are just god damned lazy?

A&E is rammed with people who shouldn't be there. They should be at GP or minor injuries or MH services, but they can't do that because those services have been comprehensively fucked over, so they go to A&E, often walking.

Last time I needed a GP appointment the waiting time was 6 weeks. This was for a medication review for my inhaler. I did run out before the 6 weeks were up but luckily didn't tip over into having a full blown attack without my meds, which would have seen me walking into A&E with no obvious injury.

I have been bollocked for a DNA for DS1 at hospital. I didn't have another appointment and the consultant told me I was wasting his time with the first one (was referred by the health visitor for unexplained weight loss). That was 12 years ago and it's still brought up every time DS1 sees anyone about his lack of growth. ('Oh, but I see you didn't attend in 2002 so you can't be that concerned...')

We ended up phoning 111 yesterday which is listed on my husbands surgery as their OOH care option and we (as expected) got sent off to A&E.

It wasn't something I felt happy about leaving until our local MI unit opened on Monday morning or for a GP appointment, but also didn't need A&E but that is our only option locally.

I was impressed though as we were in and out within 45 mins but was 10am on a Sunday morning and I was asked by two seperate receptionist if we were there for my 6 month old whilst waiting to book in. We all had to trek out as husband couldn't drive due to eye problem!

My recent experience of casualty is very poor, we went to out of hours then were sent to A and E it was like a war zone people being seen in corridors , only one toilet which I had to wheel my daughter and it is situated out in the waiting room with all eyes on you when you go out to use it, and it was disgusting too.We went in at 10 and were seen at 3 am . Yes there were a few time wasters when I sat out in reception, someone had a sore eye and had had it all week, it was by now 1 am I think he should have tried to see his GP. We are getting a big new hospital in Glasgow I hope the casualty is up to the job as they are closing other ones and all going to a central point but I think it will probably be understaffed as the volume of pts using it will be immense.

I never understand it when they say that hospitals are bursting when it is flu season. As far as I'm concerned, if you have flu you are far too ill to go to casualty! Some people do have underlying conditions, but I've heard so many people say they are going to the doctor/casualty because they feel so bad - well, they can't feel that bad if they can get out of bed, get in a car and wait hours to be seen. When I've had a real dose of flu I've just curled up in bed sweating and shivering for days - real flu means you can barely stagger to the bathroom, let alone get dressed and go out.

Brenda - It is because of elderly people with COPD and asthma who get admitted to hospital with proper flu. They get admitted because they are struggling to breathe. Anyone going to hospital just with flu, is BVU

real flu might mean you have been taken to a&e by ambulanc because you are so desperately ill.
add in infction control (takes time and recources) and you have longer waiting times.

Obviously if someone is carted off in an ambulance they are really ill - I'm talking about those people who go to the doctor's, casualty even, when they have flu. Yes, you feel pretty bad, well, horrendous, really, but why the hell are you going to hospital?

Brenda - Then that is awful, they should simply be resting.

If it isn't serious then there are quite a few options but some people don't seem aware of them. Get an emergency/triage appt at your own doctors or call 111 or go to a walk in centre doctors surgery. All these mean not needing to go to a&e. If you do need a&e these services will tell you as well!
I scratched my eye ball and got a triage appt with my doctor as it was a Friday evening the doctor told me to go to a&e to see an eye doctor. I felt silly as it was such a small thing but as a contact lens wearer they said it was important. I'm glad I went to the doctors first though. 9/10 you won't need a&e.

Ok its the daily mirror, but the article claims that the average number of no shows is the equivalent of ONE DOCTOR a week for your average GP surgery.

www.mirror.co.uk/news/uk-news/missed-gp-appointments-cost-nhs-5119794

I can understand why medical professionals over book, but I would be surprised if they over booked to this extent.

This BBC website shows that some interesting and cheap measure can improve no show rates.

www.bbc.co.uk/news/health-17298612

This Daily Fail article says that 2 in 3 GPs think that patients should be fined £10 for missing an appointment. Doctors know their patients best and if they support giving fines then I feel its something to be considered. Personally I think £10 is too low as it would not cover the costs of collection.

I wondered why there were so many no shows. I know I missed an appointment I had been waiting for for months. I was ill and just got confused about the date. I phoned and apologised as soon as I realised.

I never understand it when they say that hospitals are bursting when it is flu season. As far as I'm concerned, if you have flu you are far too ill to go to casualty!

It's not because people turn up at A&E with the sniffles. It's because A&E gets a bit busier with people with chest complaints and the wards get a lot busier with people who are ill with flu, particularly people with underlying medical conditions. This means there is nowhere to shift people too who are turning up at casualty for other reasons like pancreatitis or heart attacks so they fill up the trolleys in A&E.

Our hospital opens up an overflow respiratory ward over winter. Because those with COPD and severe asthma are more likely to be admitted over winter. Not all will have flu, but these are the kind of people the hospital means when they talk about the flu season.

A lot of NHS appointments are made by the patient phoning up and agreeing a time. If you have actually phoned up and and agreed an appointment time then there is really no excuse for missing it. (Unless you are in a vunerable group like the elderly or have signifcant learning difficulties.)

My grandfather died of flu at the age of 87 year old. (Strictly speaking he died of a heart attack induced by his body fighting flu.) I don't see any problem with very elderly or anyone else who is SERIOUSLY ill with flu going to A and E. My grandfather's dose of flu was a little bit more than the sniffles.

textfan
I think that GPs are have a good idea who is plain lazy and which patients "lead complicated lives" and who has dementia or mental health problems.

"Are carers that have suddenly had to deal with a related emergency."

Prehaps we need the facility for someone to send a text message. Its just common curtsey. It take all of 30 seconds to send a text message, cancel an appointment over the web or telephone someone. I think that there needs to be an appeals proceedure against being fined.

However we need to be cruel to be kind IF the NHS is to survive. Having 1 in 7 patients missing an appointment is not acceptable. The risk of a fine would make people get their act together and remember the appointment or cancel beforehand if they cannot make it.