To think the NHS is already on its knees and people shouldn't just cancel or not turn up for appointments without consequence?

[youarenotkiddingme]

This has been sparked by a situation by a friend but is a general AIBU.

My mum has cancer and has been treated amazingly by the NHS. She's attended all appointments and rearranged where absolutely necessary as soon as letters have arrived. As a family we've seen the best the NHS has to offer and the dedication of its staff.

I'm undergoing extensive dental treatment and often see the signs about how 30-50 people didn't turn up for appointments that month. Afaik dentists strike patients for doing it more than once.

However this holiday a friend has cancelled optical appointments on the day half an hour before the appointment for all her DCs because they want to meet friends or have had a sleepover the night before and don't want to go.
Both times these have been rearranged.

However I can't help thinking with such stretched resources there should be consequences for doing this? Maybe some financial penalty (set payments for missed appointments without suitable reason) or a time penalty before you can rebook?

There are people desperate for appointments who are waiting long periods of time when they could have been seen.

AIBU? Am I thinking this issue can be solved more easily than the reality allows? I'm interested to hear others views and any solutions people know of and have.

I get free prescriptions and dental treatment etc. But for me that makes me even more responsible in turning up. But I know some people have the attitude "I'm entitled to it so should get the appointment" but don't actually think it matters if they decide they have something else better to do.

I'd feel awful not turning up - I value the fact I'm lucky enough to get access to free healthcare and across to free services within the cost field due to low income.

It's so hard. There must be an answer somewhere. But I do think if it was an easy one even the government would have employed it by now!

Certainly one of the issues seems to be letters in snail mail.

I've also had the "you need to make a smear eat appointment" letter 3 times. The appointment had been made! But obviously o had to wait for a time i could make when I didn't have my period!

Our GP surgery is now run by Virgin Care. And they have moved premises as well so its now a 45 min walk from the town centre.

DH was put on a a medication called Ramipril and has had an adverse reaction to it and doesnt feel up to going out at all. He was given this medication to lower his blood pressure. It made him cough constantly.

Hes tried to get a telephone appointment with them on the phone. After ringing several times this week and waiting on hold (its not an 0800 no. either) he finally got told he cant even have a telephone appointment until two weeks time . Yet they are advertising to take on new patients. They have also employed a pharmacist who aims to see at least 50 patients a week for medicine reviews. More money spunked by Virgin Care. So they can screw the NHS for as much as they can. A pharmacist just piss patients about doing so called medicine reviews. So you cant get an appointment when you need one but they want to drag you in every so often when it suits them.

And if you start charging ppl £10 a time they will expect a better service if they are paying.

Well I've missed three appointments in the last ten years according to the NHS.

The first I missed because the "you have missed your appointment we made for you" letter arrived the day before the "this is when your appointment is" letter.
The second one I "missed" was one for one of the dc to check a growth. We were referred in April, appointment letter came through in June, not too bad. But when we'd been referred it was growing rapidly. It stopped growing end of May and by the time the letter came was then shrinking rapidly. So I phoned the automatic line and cancelled the appointment under the code of "no longer needed".
The third I missed because it was a regular appointment for ds at ENT and a week before he was rushed in urgently. I asked the doctor when in if he wanted to see him next week, and he said "no, don't worry I'd cancel the appointment". he obviously forgot.

So not all missed appointments are the patients' fault.

I particularly like the inefficiency of my mums hospital - despite me asking & her agreeing with them to send appointment letters & phone calls to me they still contact her directly which would be fine but it's for the memory clinic as she has Alzheimers (with particular problems with days, dates & times) so she promptly forgets, sometimes we see the letters or speak to her just after they have phoned so I get the details and can remind her or make sure someone takes her sometimes I only get the DNA letter. I brought it up with the clinic and funnily enough its a common problem with their patients

He. It's a nightmare. 5 patients DNA'd my clinic this morning. It's an MDT clinic with 6 different disciplines working together to provide care.

The same patients will complain about wait times in 2 weeks when they decide they'd quite like to be seen.

A £10 deposit would go a long way to reducing this.

Bodices I agree. Clinic of 42 pt 0900-1300 with 5 DNA was almost bearable today.

That said, please don't DNA. It takes ages and ages to chase.

I agree with you about NA appointment for trivial reason and denying another patient of speedier treatment.

I am having an ongoing plan of dental treatment...my NHS dentist has cancelled three appointments due to illness/weather/other reason. I had to take time off from work, accept 'these things happen'...Would there be a compensation scheme along with the penalising non attending?

I had an appointment with a consultant recently. The letter said if I failed to attend it would cost the NHS £135.
I do wish people would realise what they have and treat it as a valuable thing. If we had better MH and geriatric provision, better disability provision etc then maybe we could target the casual disregard.

Exploded that's a really good idea, to put the cost in the letter.

Unfortunately most people would object strongly to paying even a small contribution & see it as their right to have "free" healthcare.

"Free" equates as "Valueless"

Even charging for DNAs would help, as the dentists do, but no-one is prepared to make it happen might lose an election

I on several occasions must be one of those advertised missed appointments. I am patiently waiting for the letter to say when my appointment is then I get a letter saying I missed the appointment.

Now I have to go back to booking in again and it takes several months to get an initial appointment
What about when you attend the appointment and have been given your number and after an hour you are questioned along with several others what you are doing loitering in the surgery only to find the doctor has gone home. That had happened several times with one particular doctor. Would we be entitled to payments for our wasted time.

I bet people asking for compensation are the same people who arrive late for their appointments and moan that it should be fine as the doctor/dentist runs late.

Very entitled.

Only £135! A private consultant appointment is nearer £500, bloods £80 a shot and private scan £100 at least.

But yes, put price tickets on everything in an effort to make patients understand how very fortunate we are with our NHS, too often it's taken for granted and seen as valueless - just another entitlement.

Why no central login? As my consultant pointed out- because the computer system was not designed for efficiency, but to make more systems (all costng more money from private providers) necessary. Hence the NHS is totally computer-inefficient.

Our GP surgery is fabulous. Everyone says so, they have a very high rating, operate a sensible booking procedure (I've never had to wait more than two days to see a Dr), very good admin, very good receptionists, and they seem to have a considerably lower missed appointment rate than a friend's surgery. Friend's surgery has appalling receptionists, poor admin and takes weeks to get an appointment. Their missed appointment rate is high.

At the same time, we have two large hospitals within 9 miles of each other run by the same trust. One hospital is wonderful, the other? Well, I'd rather die at home than risk going in there quite frankly based on mine and other's experiences of both places.

I'm self employed, so taking time off for appointments "costs" me. I turned up for a dentist's appointment that I'd booked in person at my previous appointment to find it had been cancelled. I asked why they hadn't called me? They said they had emailed me and called me. I had had neither. They checked their records and had a totally different number against my name (not even remotely like mine) and had made an error in my email address. Both of which I had provided them with by form at my previous appointment and the email address was in block capitals and really shouldn't have been copied incorrectly.

I strongly suspect that probably half of all "missed appointments" are due to admin failures at the NHS rather than the majority being laid at patients' doors.

I bet people asking for compensation are the same people who arrive late for their appointments and moan that it should be fine as the doctor/dentist runs late

Sometimes the doctors and dentists are running late because they started late, not because their appointments are overrunning.

Funnily enough, my non-NHS dentist rarely runs late - and if they do, it's a few minutes at most.

NHS orthodontist is always running late, as do GPs.

Conclusion - you get the service you pay for, and being a taxpayer does not count. Also - when people have to pay for appointments, they phone to cancel them if they can't make it.

Other countries charge for GP appointments, they've obviously got around this conundrum. If people had to pay, they would turn up or cancel.

However, the inefficiencies of the appointment systems need to be sorted out. There used to be a choose and book system so you could make your own appointments. Sending out late letters about appointments is obviously going to lead to problems.

There is blame on both sides - lazy patients and inefficient NHS procedures.

Not that often..its not worth it for NHS dentist to run late..too stressful

A private consultant appointment is nearer £500

My mother paid £200 recently - in the south west. Are you in London?

They seem to regularly overbook clinics because they expect some no shows, how else can it be explained

Actually my clinics are regularly overbooked for 2 reasons, none of which are this.

1. In my new patient clinic we are up against targets and regularly receive more new referrals than we have space for. So I need to see extra patients in order that we aren't fined for breaches for these patients. Because of our setup, where I know that patients have been called to inform them of their appointment, if they DNA I am not prepared to send them another appointment and exacerbate this issue, so yes you will need a new referral.

2. In my results clinic I regularly overbook because otherwise my patients (who are mostly waiting for results about possible cancer) would wait for longer. So I'm often seeing patients non stop between 8.30 and 2pm, when my afternoon clinic starts, in order to benefit them and reduce their wait and associated anxiety.

The reason for 2 hour waits is because everyone is told to turn up at the same time- eg 2pm. This is based on the belief that X percentage won't run up at all

This might be the case in some places. It is categorically not the case in my clinics, or in anywhere else I have worked in my 20 years in the NHS.

Undoubtedly admin errors cause some Dnas. But patients have an unrealistic expectation of what is reasonable in an over stretched NHS that is on its knees, and want appointments at their convenience rather than accepting that if your appointment is important you sometimes need to suck up missing work / school / your hair appointment (yes, I have had a patient leave part way through an appointment that was expected to last several hours because she didn't want to miss this, then expected to be able to take up another appointment to complete her investigations). The NHS is a valuable resource that we will lose if this kind of behaviour continues (and I'll say again that I know this isn't the whole problem, but I know I'll still get pulled up on this)

I'm having surgery today and sitting in the ward, the woman who was supposed to be addmitted across the bed from me hasn't turned up, the consultant had come up twice to check and talk to her but no sign. Missing an appointment is bad enough but I wonder how much this no show has cost, plus the fact someone else could've had her slot.

There used to be a choose and book system so you could make your own appointments

There still is. It's called e-referral now.

Someone else referenced why don't we have a joined up service where complex patients (eg elderly with multiple medical problems) can be seen under one roof with one budget.

It's coming. Google 'accountable care organisations' - due to be piloted in a couple of regions in the near future. A great idea but not without it's issues, largely because of how entrenched the current situation is, but to debate the pros and cons would take a whole thread

There used to be a choose and book system so you could make your own appointments

There still is. It's called e-referral now

Sorry should have added this in above. While this is a good idea for lots of reasons unfortunately it often means patients /gps pick appointments which aren't suitable leading to more wastage for the NHS and more frustration for patients. For eg one of my clinics has early slots that are for people suitable for specific investigations only, and there is a note to this effect on the system. Regardless, unsuitable patients are booked in (because the patient prefers the time and thinks it won't matter / it's the only slot left / who knows the reason)

Here we pay for GP appointments (with discounted rates for pensioners and those receiving state benefits). Kids up to 13 are free in my area.

However there are issues with people not going to GP due to cost and getting significantly worse and needing admission to hospital AND overuse of A&E by those who should really have gone to a GP (so sit and wait for hours clogging up system).

The hospital system is free once referred but there are still significant issues with people not attending appointments.

I can't see any easy solution. Personally I preferred the NHS system so everyone got seen who needed it - with a focus on prevention.

I was once my GPs second appointment of the day and she was running 30 minutes late. I didn't comment as I was going regularly at the time (MH issues, signed off work for months, several changes of medication needing regular reviews) and this was unusual so I assumed it was for a good reason, when I did go in to see her she apologised and explained she'd been sorting out an urgent hospital referral for the previous patient to get him there straight away. Obviously very urgent and something that couldn't wait for four or five hours til morning surgery was over.

It annoys me when people say to things like this "but I have important things to do too!" Really? As important as savings someone's life by getting them where they needed to be? Really? Then why are you even in the GP surgery and not doing whatever important thing you have to do?

I've never appreciated the NHS as much as when I needed medical care in Ireland at the time when an E111 still meant free healthcare. I needed three or four GP appointments (€50 a pop twelve years ago) bloods and urine tests (€100? I'm not sure) and several medication (more € but not sure how much). All free. And if I had been in the UK I wouldn't have even thought about the cost.

I've missed appointments because of letters not turning up (or not even being sent out!). I've also had to re-arrange a physio appointment several times because of receiving the appointment letter too late to arrange childcare. I don't think the fault lies solely with the patients.