NHS piss takers. Selfish, self absorbed people

[ThornsWithin]

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.

I see a couple of issues here:

1. peoples health is seen as something to ‘fit in’ around everything else - people feel obliged to only be “quickly popping out from work” to fit in an appointment rather than both employees and employers recognising the importance of health.
2. if people can’t be bothered to make an effort to turn up, how badly do they need the appointment anyway? Or is it again a case of failing to recognise the significance of it?
3. for all the people saying “make them re-book” - that’s great, so that one user gets twice the time allocated to them but others can’t get in for weeks because of all the re-bookings?
4. for all the people saying “but the clinic is always over running anyway” - yes, because of other people who turned up late before you too, and - if you need the appointment, then wait!

I do wonder how much more efficient it would be to have skype appointments for some clinics/appointments.

You sound like a good NHS employee, OP.

However, your manager needs to be more supportive.

If a pt arrives more than 5 minutes late our receptionists must advise the patient they may not beseen and it is the discretion of the clinician. We explain that our staff have fixed working hours and personal commitments that mean we cannot always accommodate those who are late. We suggest they call in advance if they are going to be late to ensure they will be seen. But... there is absolutely no way I would expect one of my clinical team to stay late to see a patient who is 15 mins late for a 20 min appointment. I'd back you to say no if you worked for me :)

Its quite tricky sometimes - I have appts at various places over two towns both of who get heavy traffic and at the moment have autumn roadworks blight meaning to cross to the other side of second town (they are adjoined) can take an hour or more when if all the wind is blowing in the right direction it takes 10 to 15 minutes, its very hard to judge it right. Once when it was particularly bad (I knew it was and set off an hr earlier than I would have but was still 30 min late) I phoned ahead to let them know we had issues and they said its fine just come when you can but be prepared to wait. I think that has to be the answer if over 10 minutes. Yes you will be seen but you will need to wait until there is a gap in the schedule big enough for your appt, of course we can rebook ...

Really often, I arrive in clinic to find they are 1 - 1.5 hours late and I've seen patients have to.leave without being seen because they've got to get back for work or childcare. If you are refusing to see patients who arrive more than 10.minutes late be prepared for them to complain bitterly if the clinic isn't running on time

I agree with this

We have a 15 minute rule in the NHS clinic I work in. We've put up some very clear signs in the waiting room saying that if you are more than 15 minutes late for your appointment, it will be marked as a DNA and if you DNA twice you might be discharged. It seems to work, but you always get the exceptions who think it can't apply to them

There are reasons why people are late of course, the top one is NHS transport running late which is most of the time, chaotic mental health, the very elderly taking ages to get in and out of a taxi even though they have tried to leave early to cover this and so on. These people I'll try and see, you often get people coming early so I'll whip them in first and see the latecomer after.
You have to use your common semse.
Mostly I ignore rude people, I don't know whats going on in their lives but to those who saunter in 20 mins late asking what my problem is I'm only a couple of minutes late, they get fired out of a canon. I don't have time for that.

Seriously do you not see that respect for time works two ways and the public are so used to the nhs being late, often because they are downright sloppy, and failing to communicate delays despite being seen and heard squawking about personal stuff, that people aren't punctual because there is so much experience if services being late and there being v little cognizance of the inconvenience the other way round

I also agree with this similarly made point!

Yep I hear you op. I used to work in antenatal clinic and the patients who were late would have the most ridiculous or fantastical reasons for not arriving on time. In 95% of the time they just hadn't allocated enough time for their journey or parking. 🤷🏻‍♀️what was most annoying was that they thought the staff were stupid enough to fall for the excuses.

Turns out they had shut the multi story car park that day for some reason.

That’s bad enough and I’m sure was infuriating. This hospital - a regional referral centre for a wide variety of specialties - has this problem so often that they’ve installed signs at intervals down the road (60 minute wait, 45 minute wait, etc etc). The multi storey car park is two levels - that’s it. It’s absolutely ridiculous. They employ play therapists in the waiting rooms to try and entertain kids that can be sat there waiting up to 3 hours (not sure if people have tried keeping autistic toddler twins in a packed waiting room with about 3 toys in it for upwards of 2 hours but it’s not fun - I had to go to the hospital gift shop to buy toys for them to play with as it was the first time we’d been and I had no idea).

My local hospital car park is 5x the size for a much smaller site, but even then it’s often full. We are just so lucky to have a blue badge now, but they aren’t any good if you can’t get on site!)

The thing is, when you have regular repeat patients you just know those who are always late. There is rarely a ‘good excuse’. They are just chaotic and always seem surprised that their journey took so long despite the fact that they’ve done it many times before.

In the clinical setting I ran, patients were never kept waiting. Partly because we had a very robust policy for latecomers. We were very clear that their appointment would end at the scheduled time and would not be allowed to overrun thereby keeping others waiting. Therefore, their lateness impacted on only them.

Definitely do not see them. I've had many hospital appointment these past few years and I always turn up at least 10 mins early. It's rude and inconsiderate to be late. Saying that not once have I been seen on time, I once had to wait an extra hour but I know the NHS is overstretched so don't mind.

I did get a telling off from a consultant for not turning up to my last appointment ,I did turn up but the consultant was off sick. I told him this but he wouldn't listen, the tosser!

Obviously if transport is running late, an accident on the roads, buses running late, weather conditions, being in A&e all night with a child/partner etc etc are all valid reasons for being late and can happen to anyone. But don't I think that's who the op was thinking of.

Generally not unreasonable to not see the person.

I was only late once, by 15min. Had a newborn, couldn't drive, so had to rely on the bus, which shows up every 20min and it just so happened that there was a wheelchair user taking the one space available for prams. After waiting for the next bus, running to the surgery, out of breath, wanting to tell the midwife that I was probably suffering from PND, I was in tears when the receptionist said that I couldn't be seen. It took two more weeks for a new appointment.

I didn't kick up a fuss; at the end of the day, I'd missed my appointment. It was a little bit disappointing, though, given that I'd never been seen on time at that particular GP's.

Someone came in an hour late to my clinic last week. When I said I'm really sorry I cannot see you as i have a long list of urgent appointments to see today she said - well my appointment was an hour late last week so I thought I'd do it to you.
What insane logic, the last person she saw was running late because patients were either late or were urgent cases that needed to be sent to hospital which is a massive arseache as we have to do it - write a letter, ring the unit, get antibiotics arranged all of which takes ages as we have no admin staff.
We're not keeping her waiting with our feet up having tea and a chat!! I try to explain to people what goes on behind the scenes and most are ok but the odd one you really want to tear your hair out. How does tit for tat help anyone?

I don’t mind being late into an appointment. I appreciate that it’s very hard to make appointments fit into the slot. Ds has often been the patient responsible for adding to delays because things come up in the appointment that need second opinion or more time.

I would much rather be late going into an appointment than encounter people like the dr Ds saw last week who said “the half hour is up so we will have to discuss the other issues next time”

I took over a clinic run by a lovely clinician who was a bit of a pushover & they’d stroll in late expecting she’d see them.

It was a culture shock when I turned up.

I run similar clinics. The elderly are often just as late as the younger ones IME, and as bad as not turning up at all!
I could guarantee my clinics would pretty much run to time, as the only time I run over is when seeing a 'walk in' (often inappropriately), dealing with multiple issues people bring to the appt (when only booked in for one), and seeing people who turn up late. I massively resent giving up half my lunch half hour (in a nine hour day) or going home late because of late attenders. In fact I put 'too late' on the screen and reception turn them away.

YANBU however I find it equally infuriating and rude when I visit my GP or go to a clinic appointment and am sometimes waiting up to an hour to be seen.
It means I have to take unscheduled time off work or makes me late for whatever I have planned afterwards.
But as the patient I'm made to feel that I'm lucky to even have an appointment and to just suck it up.

@OhTheRoses thank you. I try and be lovely, I'm also a heavy user of the NHS (me and DD2 have health needs, hers are extensive and we have/have had A LOT of appointments over the years) so I do understand the frustrations. Real life gets in the way, of course I understand, but a blatant disregard for my time, and my clinic efficiency and my other patients infuriates me.

I can't speak for all environments but I've never seen my colleagues regularly arrive late for work. GPs are occasionally late in due to doing home, nursing home, terminal illness or death certification visits but communication is key here - the GP calls the receptionists, says they'll be half an hour late in or whatever, the receptionist conveys this information to waiting patients. In my experience most people (me included) don't mind waiting if you know why, and roughly how long you might be waiting.

Looobyloo

I hate being late for anything. I am always early and the prospect of being late for a medical appointment stresses me out but, realistically how much time should people need to leave as a contingency? You say 10 minutes but that's nothing. As I've said, my journey to a hospital in being treated at should take 1 hour. Regularly takes 1 and a half hours. Has many times taken 2 hours and on a couple of occasions more than that. One time the tube line was suspended, thankfully while the train was in the station and I had to get a taxi to the hospital which took much longer than the train would have but equally I could have been between stations when the line was suspended and would have been stuck there. So how much time should I allow for this?

I've got an appointment coming up for 4pm. I finish work at 2pm so theoretically should be able to finish work at normal time and still get to appointment, especially bad 99% of the time it's running late anyway, but I can't take the chance. So I need to take the whole day off as I'm not allowed to take part days off. This happens repeatedly and so much that all of my annual leave is used on hospital appointments. So, as a one off its annoying but when it's a regular thing it really impacts on patients lives.

We should be making sure that services are available locally so that patients dont have to travel miles to get treatment.

Yanbu, use your discretion and refuse to see the cheeky ones. Although public transport problems and inadequate hospital parking can't always be helped, and if you've waited months for the appointment and get held up through no fault of your own. With respect, elderly patients will likely have more time on their hands and not have to rely on leaving work on time, childcare and other issues.
On the flip side I have never once been to a clinic that's running on time. And we're not talking by a few minutes we're talking hours. I was sent home from one when pregnant as it was running so late the nurse came out and told people to please rearrange. I was also kept waiting hours the next time after the consultant strolled in 1.5 hours after my appointment time loudly telling staff she had overslept. It works both ways.

Yanbu as long as

• your clinic provides free adequate parking
• none of your patients work or have family commitments which can even with good organisation and planning result in a slight delay in getting to a specific place within a specific ten minute window booked several months in advance prior to other matters surfacing on a day filled with, as days generally are for most people, many other considerations and tasks
• traffic on every route to your clinic is never problematic
• there is cheap, reliable public transport from every possible starting point to your clinic that is never subject to delays
• you cancelling appointments in a hissy fit over a fifteen minute delay doesn't mean that patients then have to wait six months for another one.

If all of these criteria apply, then go for your life and cancel them all. I'm sure there won't be any negative repercussions for the people you refuse to see, at all.

Are there regular offenders? Could you give people one chance, but repeatedly late people get told no...with some common sense if there has been a major road incident or such

Say Sharons 20 minute appointment is 10am. She strolls in at 10:15am. Mavis is due in at 10:20 but actually arrives at 10:10am. I think it’s fair to take Mavis in early. Sharon is too late.

OP, I totally agree with you. If Sharon is late and Mavis is there, then I would see Mavis. If somebody is late then they have missed their appointment, simple as that. Maybe they will learn not to be late next time if they realise that they won't get seen. Sharon can wait and be seen if you have time after Mavis, but if the next appointment is due and is there, then Sharon has to rebook and go home.

It is a very selfish and entitled attitude to turn up late repeatedly. Yes, we can all have days where the traffic is bad, or the taxi didn't turn up or whatever, but generally late people are late because they simply don't allow enough time. I am the sort of person who would allow 2.5 hours for a 1.5 hour motorway journey to ensure that I wasn't late for a concert or whatever, whereas my friend would allow 1.5 hours for a 1.5 hour journey and expect that to also be enough time to park, walk to the venue etc.... showing that we are very different types of people.

For example, my chiropodist is always 100% booked, 6 weeks ahead, so when I have an appointment, thats the earliest that I can get the next one. If people don't turn up, she loses money when she could have rebooked that appointment 3 times over because she is so busy.

People who are always late need to consider that they are actually costing somebody money.

My biggest cracker was making dd a private consultant apt for £225 at local private hospital. I explained an apt as late as pssoble would be best vis school and work. A 5pm apt was made. Two days later I got a call to say that if the consultant did not fill the oreceding slots dd's apt would be brought to an earlier time becauise the consultant didn't like wasting her time. I was speechless at the arrogance, cancelled and complained. Mine and dd's time had no importance whatsoever to that consultant. I did get a letter of apology from her. On the afternoon of the cancelled apt I got a call asking where we were.