NHS Appointment System Screw Ups causing wasted appointments

[Teentrauma]

Our area uses an online system for appointments where you receive a text from which you can download the appointment letter and have the option to confirm, rebook or cancel. You then receive a text reminder a week before the appointment where you get the same options again. Initially I thought it seemed all very efficient and time saving but now I'm not so sure.

My son had a follow up appointment booked in May for something non urgent. A week before, something unavoidable came up which coincided with the text reminder so I clicked "rebook" which was acknowledged. A week later a new appointment was texted through for a couple of months later which I accepted. A few weeks later we received a letter from the consultant saying we'd failed to attend the original appointment and, having reviewed the file, they were happy no further appointments were needed and were discharging him. We were happy with this as didn't feel the need to attend to be told what we already knew but felt bad they didn't get the cancellation and wasted an appointment which they said was worth £160. I assumed the rebooked appointment would automatically be cancelled

It clearly hadn't been as several weeks later we received a text saying they needed to reschedule it, offering a new date for November. I clicked "cancel - no longer required" and received a confirmation. Then yesterday, I received a reminder for the same appointment (it's next week) so it clearly hadn't been cancelled! I clicked cancel again and received confirmation but hope it actually has been cancelled this time! While I'm tempted to call and confirm to be sure the appointment isn't wasted, I can't be bothered to sit on hold for ages!

No idea whether this is a human or system error but, either way, it's not helping what is already a service in dire straits, assuming this is a common occurance.

Anyone else experienced this?

Sheer madness..

YANBU. I had a referral to the hospital outpatients for a non-emergency issue about this time last year. Had a call around February saying that they were just checking I still needed the appointment and I confirmed I did.

Nothing until about May, then a letter arrived at 2pm one Monday, with an appointment for THAT SAME DAY at 5pm. Luckily DH was working at home that day as was I so I could drop everything and go. Had it been the following day, I would not have been home until 6pm and would have missed my appointment. I did mention it to reception when I arrived at the hospital and just got a shrug of the shoulders.

And the letter was postmarked and dated the day before, so it's not as if it was down to postal delays.

Yes I've had this too. Waited ages for an appointment for my toddler. Received a letter with the appointment details - which was for 3 days before I actually received the letter. I called the hospital and the lady laughed and said "that's been happening all the time recently"... I did not think it was funny! Especially when I got a letter a few weeks later saying that I'd failed to bring my child to their appointment!

Write to PALs

The NHS must waste so much money because of admin fuck ups - I can't begin to imagine how much. There has been a whole thread of letters in the Daily Mail on the subject and it's happening all over.

We have been dealing with elderly MIL since April, she has Alzheimer's and had to have a heart op, and NHS organisation is totally non existent as far as we can see. We had two district nurses visit her when she wasn't at home because she had been re admitted to hospital, a visit from someone to give her her Covid and flu jabs, a phone call consultation from one of the GPs and her weekly drugs had been delivered, even though she has been back in hospital for a month and both me and DH have spoken to various people in our GPs surgery on national least three occasions.

This is why people keep saying there is no point giving them more money until this waste - which is down to poorly designed systems - is dealt with.

In Spain after the 2008 crash the health service had its budget drastically cut but it actually got better and more efficient as they simply couldn't afford to waste all that money pissing about.

All organisations waste money because of admin screw-up's BUT in efficiency terms, the NHS scores highly in international comparisons - yes letters to the 'Mail are highly scientific.

So, district nurses are managed via GP surgery, so you never told them your MiL was in hospital?

We had very similar with FiL and a leg op, coinciding with unrelated eye treatment, by informing the eye infirmary, we avoided waste.

The monies have not been spent on computerising all record keeping and linking into (privately run) GP surgeries, so we have to do our bit and stop expecting everyone else to do it for us.

Perhaps the tories being responsible for 110k staff vacancies in the NHS (over 130k in social care) and under funding it, in real terms, over the last 12.5 years, is the reason it messes up?

@walkinginsunshinekat

❤️❤️❤️❤️ This, 100%.

So, district nurses are managed via GP surgery, so you never told them your MiL was in hospital?

I said in my post we did tell them -three times! Following the call from the GP on Monday we now have to tell them for a fourth time! Is it too much to expect that a surgery record this fact so that the staff in the various sections can see if a patient is in hospital or not? Do we have to ring each doctor, the pharmacist and the district nurses individually ourselves? This is pretty much what we have had to do. What happens if patients don't have family members to keep the NHS up to date?

Incidentally, the favour is not returned and we are not kept in the loop at all.

When we were going through this with my DM 10 years ago the GP was brilliant, they were the central hub and was totally on top of things. Now they don't seem remotely to care and haven't got a clue. They prescribe the wrong drugs, or the right drugs in the wrong dose, sometimes drugs get missed when there is a transfer back into hospital from home. We have had to check things a couple of times and have found these quite serious errors.

Could not agree more.

DD has had some health issues over the last couple of years and we’ve had stuff like this all the time.

Several times we’ve had letters for appointments sent out after the appointment date. Then another letter complaining that we didn’t attend said appointment

I had to cancel an appointment for a 24 hour EEG (so 2 appointments) as the removal appointment fell on a day DD had a GCSE exam. Called the hospital, asked if we could change the date and explained why. Given a new date for the following week, all fine. Until I get a letter complaining we hadn’t attended the original appointment - it obviously hadn’t been cancelled. Human error and a simple mistake, it happens, I phoned them, apologised, they were lovely, it was sorted and not a problem, but it still ended up 2 wasted appointments plus admin, letters, postage, etc.

I also get copied in on letters between the Paediatrician and DD’s Neurologist. They’re disagreeing on DD’s care and they’re so rude to each other it makes me chuckle, but at the same time, can’t this be done by email? Do I really need to be copied in on every letter? There are dozens and dozens of letters

This is nothing new. Happened to me 23 years ago, whilst awaiting a hysterectomy- scheduled appointments sent by letter, but for dates that were before the letter was dated and sent. No way to attend them unless I had a time machine. Nothing has changed. Nhs seems to be institutionally programmed to waste money but blame the patient.

OH had a call on Monday asking why he hadn't turned up for his Covid vaccine and flu jab. That would be the one he was never told about. The woman on the phone started off a bit shirty but was quite profuse in her apologies when he explained.

@TonTonMacoute Ok missed the bit about you speaking to GP surgery, sorry - but that seems to be down to the GP practice not NHS ?

We cannot digitise the entire NHS over night, it would take decades and be constantly on going - plus look at what happens when privately run organisations upgrade IT? Banks and Airlines for example - complete chaos!

I ve friend who was on rotation as an OT, she was in an out lying setting, with full computerisation but only with one trust, when she had a new patient (from a different trust), had to write up paper notes to get them on her system and when discharged, print them off! even her local district hospital isn't fully digitized.

What i'd like to see is to get the current system working, then look at re organisation and that means far fewer trusts, sooooo much duplication and different ways of working.

But first pay rises and staffing needs sorting.

Pretty similar situation here, @Teentrauma. This happened to me in late 2020, so it’s disappointing to hear it’s still happening.

I pressed ‘re-book’, got the message that ‘the team will contact you’, and all that happened was I got a snotty letter from Audiology discharging me from the service for being a DNA. I can imagine it’s as frustrating for them as it is for patients if they don’t get the info.

I still haven’t been seen, as it happens, what with one thing and another.

The system in our area is computerised (as I said in my OP) but still the cock ups happen. I'm wondering if a human still has to inform the relevant departments of cancellation requests etc, rather than a notification being pinged to all concerned, which makes it not much better than the paper system if the human concerned is overworked/inefficient. Anyone work with such a system who can enlighten me? I'm taking bets on whether I'll get a letter complaining about us being a no show, despite cancelling this appointment twice.....

My dad very sadly died of cancer earlier this year. During his treatment he "missed" three appointments with his consultant. The reason being he was given dates & times at his preceding appointment which were subsequently changed, but no letters ( all communication was via letter, no emails/texts) were sent to him to advise of the changes. The worst of these was his appointment after a scan at the end of his chemotherapy to see if treatment had worked. The appointment was changed, he was not told and then had to wait a further two weeks for a new appointment to find out the results. On another occasion the consultant phoned to see if he was ok and he was extremely embarrassed at missing a rescheduled appointment. The consultant seemed unfazed and implied it was a fairly regular occurrence.

Due to the type of cancer he had he was treated at a specialist cancer centre and he was one person with three "missed" appointment. I wonder how many appointments are missed/wasted in a year due to failing IT and administrative errors, but based on our short experience I would estimate a significant number.

Oh don't start me. DH has various health conditions and is dealing with 2 different hosptials. The post room at the London teaching hospital is appalling- 2-3 weeks for an appointment/clinical update letter to get in the post, based on date of letter to post mark date. The clinical nurse specialists have taken to ringing the day before to confirm. And we went into London during rush hour so mega bucks rail fares, to wait for a couple of hours in Out Patients to be told that he had been booked into the wrong cardiac clinic. The words were "you need an electrician , I'm a plumber". The GP had referred him to an cardio-physiologist. It was funny at one level but quite worrying as there was 6 week wait for another appointment, which was supposed to have been expedited.
The local hosptial sent him a snotty letter about a missed appointment ( for his Cancer investigation) with another appointment . He hadn't received the inital appointment. Like PP he has also had letters arrive on the day- luckily they were confirmations as Clinical staff are ringing about appointments.
So its not only a waste of appointment, but a waste of Nurse's time as well.
But the NHS has too many clerical staff we hear!

Had the same with my DD.

I clicked "rebook" the day the message came through as we were out of the country when it was due.

Got confirmation it would be rebooked.

The specialist still called us, and as I was in an underground cavern, it went to voicemail

Came home to a "discharged due to failure to attend"

Took weeks to sort out.

Also, why does it cost the NHS £160 for a missed appointment, but an appointment with a private specialist and treatment costs £150?

We are always told how many appointments are missed and how much this costs the NHS but I imagine a large number are admin/NHS fault than people simply not bothering to turn up.

DD had a course of dental treatment at the local hospital. All the appointments were during the school day and due to location of hospital usually involved 2 hours off school for her and a day off work for me. On about 3 occasions I needed to change the appointment because either she eould miss exams/I couldn't get that day off work. Each time I would call the number on the letter (with 1-2 weeks notice) and either speak to someone, or leave a message.

Each subsequent apt we would get reprimanded (either by the receptionist or clinician - or both!) for being a no show at the missed apt.

It was really frustrating and I feel aggrieved that we would essentially be included in their stats for missed appointments, when I had followed their own instructions on what to do if you are unable to make the apt.

My elderly uncle received letters for appointments on the same day. He didn't have his own transport and was quite a distance from the hospital, so was unable to get there.

In our trust, it is computerised up to a point.

My colleague’s wife works for our CCG and it’s a regular rant of hers. Half our GP surgeries all use different systems. My surgery is one of them. They’ve been trying to get all the different areas to work together to sort this out for years.

DD will have an appointment at the hospital, then all notes have to be written/typed up and then sent to out GP who then have to enter it on their system. Regularly takes weeks for records to be updated. However, CAMHS and the hospital are linked up and everything runs so much more smoothly.

The appointment cock ups have happened so many times, that I now have direct contact with the paediatrician’s and neurologist’s secretaries and they email me direct with appointments. CAMHS are the only ones to have their shit together

I think the system is generally inefficient.

I missed a doctors appointment recently, the receptionist definitely told me it was a telephone consult. It wasn't.

I suspect it’s human error OP. I have experience of a similar system - clicked the rebook option from the text message and was astounded to receive a phone call from a human literally a minute later to rebook my appointment. So I think clicking the option triggers a request for a human to do something, and I suspect each department works differently in how they rebook - in my case by phone. All went smoothly for me, no missed appointments, so I guess in your case they forgot to cancel the original appointment.

I would actually email my MP with this. Imagine the number of people cancelling or rescheduling and all those appointments are still left on the books. That is a huge waste and is probably a system flying under the radar which no one cares enough to sort.

MP's are the first port of call for failing policy. I would email mine and tell them and ask what is being done to stop this huge waste of public money.

I don't think this is necessarily an online system issue. It's an inefficiency issue.

We've had the same - minus the fine, as far as I know (I hope not) - with dd for a physio appointment. Dd needed an operation over the summer and after we were discharged from the consultant to physio. Went for one physio appt and it went well and she gave us some exercises, but basically said dd was pretty much there and could resume all her normal activities in 2 weeks time. She booked us in for a final follow up appointment 3 weeks later and just said to cancel if we didn't need it.

As the appointment approached, I rang to cancel because didn't see any point in missing school and work for them to just say fine and discharge her. I said we didn't need any further appointments. Then got an appointment letter (through the post) for a re-scheduled appointment for several weeks later. This one I did completely forget about as I just thought it was a discharge letter and didn't realise they'd made us another appointment. I called to apologise and say thanks, we don't need to re-schedule though because all is fine. I just got through another appointment letter for a future visit this week. The effort spent on setting up these appointments and chasing them up and having to speak to me to say, no, actually we don't need it, please cancel, etc.

Have had exactly the same thing just this week OP.

Got text so I rebooked appt then get a letter saying we had failed to turn up so she was discharged.

This is BCUHB - I dont know if is the same board you are with or if its a nationwide problem