NHS piss takers. Selfish, self absorbed people

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Without going into specifics, I work in a clinic and see people by appointment. They have an allocated time slot ranging from 10 minutes to 40 minutes depending on what I’m seeing them for. Since I started this job I’ve become amazed and frustrated with how many people think it’s fine to stroll in late. Sometimes upto 30 minutes late and still expect to be seen. Once they’re 10 minutes late we can mark them as non attenders but half the time, they stroll in after that time and get at the receptionists about how they “must” be seen - the receptionists then come to us panicking and we end up seeing them to keep the peace. These people don’t give a shit that their behaviour puts the clinic way behind, makes other people’s waiting times much longer, causes staff to be off late ... and half the time they don’t even have an excuse for being late! We get “sorry, I forgot” or “sorry, I got talking in the shop” or even “sorry, I didn’t want to get up this morning! Hehe”

It’s a joke. What makes it even worse is when they stroll in late, check in and then bugger off to go to toilet or get a drink! You’re already 20 minutes late ffs! At least get a shift on once you’re here!!

AIBU to literally refuse to see people once their 10 minutes late thing is up? It would make me unpopular with both patients and staff but I’m sick of the piss taking. I’m sick of getting home late because people can’t be arsed to turn up on time.

I wouldn’t dream of strolling into an appointment 10 minutes late, why do people think this is ok??

Or should I be more tolerant?

Btw the clinic is not mental health related or urgent care.

Ido think that QueenofPain has a point with regards to older people being on time often because it’s easier for them. Often they don’t drive so a taxi drops them off at the door. Or in the case of my retired parents, who drive to appointments together, if there is a parking issue then one drops the other off at the door while the driver goes to find/wait for a space. I do find that as a lot of people get older their appointment is the one period of activity in their day, so the whole day is geared up around that and they either don’t have any other prior commitments or refuse any other commitments “because I’m going to the hospital that day”.

It’s a different story for working people. If you work in a school and don’t get any leave allowance, it is horrible to have to attend an appointment during work time as you feel terrible guilt on top of the stress of getting there or the worry of the health issue itself. You know your not being there has caused loads of issues. I know what it’s like to be answering your work email on your phone while you’re waiting in a clinic that’s overrun. Add in tight timelines for eg school pick ups etc and it gets even more stressful.

Maybe the answer is for everyone to get taxis even if they drive? Although that’s awkward if you’ve had to leave your car at work miles away and it starts to look like you won’t have time to return to collect it before the end of the day/you have to collect kids from school.

However, I also agree that for people who have a laissez faire attitude to being on time are often the product of a school system where there is minimal consequence for being late or not doing homework. Pupils often just don’t turn up to detention because their own parents didn’t so won’t enforce it in their children. They simply think that the rules of society, put there for good reasons, don’t apply to them. Those sorts of people should definitely face the consequences of being late for an appointment. They want their rights but don’t want any responsibilities.

I think if the appointment is 10 minutes and they arrive late, tell them they’ve missed it and will need to rebook. Make it very clear on letters or at time of booking.
If it’s a longer appointment, use the time to catch up on other things, and when they arrive tell them they can have the remainder of the allotted time, so if they’re 20 minutes late for a 30 minute appointment, tell them they can only have their final 10 minutes as you can’t keep other patients waiting, especially if they just didn’t get up in time etc. If that isn’t be long enough, give them the option to make a new appointment.
Don’t give them the option of waiting until the end of the day, I assume it’s rare you’d have extra time, so just don’t offer it.

Bil once refused to treat anyone that swore when he was in a particularly bad mood

you cant blame this on the NHS.
this is the fault of those turning up late.
Leave yourself more time and definitely dont stroll in and get a coffee, they dont seem to find the OP an important part of their day.

op do they come back to you regularly?
can you tell them when you rebook?

They could sit and wait to see if someone else does a no show, or if a person is late, take the late shower in, then when they turn up do the same. It’s a domino effect. You turn up late you wait for a space.

This. I never understand (I attend many NHS appointments so watch what goes on) why a Dr calls for a patient who isn't there. Dr goes back.into room, comes out 5 minutes later and calls again.Still not there. Eventually after 15 minutes they call.in a different patient. This is in a full clinic that's already running an hour behind so no shortage of patients waiting to be seen. Call once. If patient not there then see next patient. If missing patient turns up slot them in later on.

Your managers need to be involved and put up a sign in the clinic saying that those who arrive 15 mins later than appointment time will not be seen. Add a lime to appointment letters too. And get everyone to stick to it.

If so many people fail to turn up, why do clinics always run so badly behind time? ie if you make an appointment for 11 you can be sure I'll still be sitting waiting to see the gp at 11.45 or later - I've never been seen on time. Surely if some people don't show up, they should claw back some of that delay?

I suppose I’m just grumpy because I feel like absolute shit, probably shouldn’t be at work but drag myself there as the entire clinic would be cancelled otherwise and patients would have a two week wait for another appointment.

It just pisses me off. I get to work 20 minutes earlier than I need to. If my first patient is due at 8:40 but get there for 8:30 I see them 10 minutes early. I go out of my way to get people seen on time (or early) then you get these people who drag their arses out of bed at 11am, stroll into their appointment 20 minutes late, sit falling asleep during their treatment (seriously! And these are not very unwell people) and then whinge that they can’t wait to get home blah blah. Neither can I mate, but it will be late for me now, thanks.

YANBU. People shouldn't do this unless they have very good reason, because it inconveniences all the other patients and staff.

Not that it makes much difference (which is fair enough) and they usually insist on it being 10 mins or whatever, but I always phone the doctors' receptionists etc if there's a possibility I might be late. That's just good manners. Usually I manage to get there with in the 10 mins in the end, anyway.

@MontStMichel you don't happen to live near J2 of the M25 do you?

the clinic is not mental health related

I do work in MH. Our appointments (30-40 mins) are often booked back-to-back.

I try extremely hard to make sure that my clients can trust me. They know when their appointment is, where it is, how long it will go on for.

If someone shows up 5 mins late, I'll see them but say at the start that the appointment will still have to end on time, i.e. be 5 mins shorter. If they're 15 mins late then we can't meaningfully do the appointment so it will have to be re-scheduled.

I can't let appointments over run because it isn't fair on the next client. (Or the other staff and their clients - we share therapy rooms and someone will need to use it after me) Everyone gets treated the same - at the time printed on the letter, I am there waiting and prepared to work with you.

Messer-abouters usually get the message the first time it happens.

do you have receptionist?
you must get a fiercer receptionist

I don't see why you do have to see them.

Tell them to rebook.

Its really tough when you're running a hectic clinic where one person being late means you could be without a lunch break and then late for all the other patients that day.
I generally say I won't see anyone 10 mins late for routine but acute I have to. A week could mean an amputation for some of them so I just get on with it.
What boils my blood is people who stroll in 15 minutes late and say well I'm only a bit late what's your problem. I'll send those people packing if they are routines.I have other patients to consider - people who are at work and can't hang around waiting for hours if the clinic is running late.

Tequila's post may have answered my question!

Op I would audit this. In my line of ( NHS) work, we need to regularly audit clinical and admin issues that have been flagged.
Record the latecomers- reasons- time wasted, and repercussions, for example, because you saw W ten minutes late then the clinic ran late and X, Y and Z were kept waiting.
Managers love a good audit where you can suggest ways to improve clinic waiting times therefore improving productivity.
I hate that everyone is kept waiting due to one individual. Can you charge late comers or no shows?
At the very least, those that are late can be told they can "sit and wait" to be seen.

People sometimes need be to be treated like children. By allowing them to treat you without respect, they’ll think it’s ok and will do it again next time. Make it clear in letters, notices in reception, and making sure the receptionists follow through. Missed appointments will need to be rebooked and can’t allow other patients to be delayed. I would dream of turning up anywhere late and just saying I just didn’t want to get out of bed, or got busy chatting to someone in the shop. Don’t let people treat your services like that. I assume they are there for help, they’re not doing you the favour!

OP I don't think it's unreasonable but depending on the circumstances. I had a similar situation as a PP where the self checkin wasn't working and had to stand at reception which then took me over the 10 minute time our GP surgery allows you to be late. The receptionist would not allow me to see the GP, which I thought was completely out of order as I was on time.

Interesting table. DD is under the adhd adult service. The adjoining clinic is learning disabilities. People turn up continually for that clinic to be told "oh we cancelled x clinic, didn't you get the letter/msg etc. People are so used to it they suck it up. It is disgusting.

Oh! And those that have genuine reasons for being late? Don't they all? How do you know that they are telling the truth? You can't differentiate fairly between one good excuse and one bad, so treat them all equally.

*i wouldn’t dream

Yanbu. Although I do often find myself wondering why I've bothered to turn up on time when the GP/hospital clinic/dentist is running an hour late. I don't think I've ever been seen less than half an hour late at any NHS appointment.

I’m a practice nurse in a GP surgery.

I am able to use my discretion to some degree with latecomers, partly because I know my patients (usually) and partly because my clinics are set up with a very small amount of flex.

So if “Cyril” checks in a few minutes late I know it’s because his wife has dementia and he probably had to wait for the carer to arrive before he could leave the house. If “Lizzy” is late it’s because I know her appointment at 1500 clashes with school kick out time and we share our car park with the school, so she probably struggled to get parked. If “Billy” is late for his immunisation appointment I cut them some slack as we all know how unpredictable life is with a newborn.

If they come in apologising or explaining their lateness to the staff we are of course more accommodating. The self check in machine won’t let them check in if they’re more than 5 minutes late so they have to go to the desk, and the receptionists will IM us to ask if we’ll still see them. I will see them if I can, as they will only want to rebook and we don’t have endless capacity. But it depends on what they’re there for, how late they are and how my clinic is looking generally.

I do think some of it is a societal problem rather than an NHS problem. We’re used to instant availability, 24 hour services, and seem to forget that healthcare doesn’t necessarily fit that model. And yes when a clinic or service is always running late it does lend itself to people thinking “well they’re always running late so it doesn’t matter if I am”. They fail to understand that the provision often runs late precisely because so many people take that attitude!

Clinicians know that traffic, parking, kids, older people, situations out of our control can impact on punctuality. It’s the accompanying attitude that can piss us off.

In principle I agree with you, OP, but the hours I spent waiting at the eye clinic with my dad used to make me lose the will to live. We were always on time but each visit took the entire morning. By the time he was 98 the process exhausted him. It works both ways.