To think that if the NHS sends you an appointment for a significant surgical procedure, you turn up>

[XingMing]

DH has waited two years for a (complicated) day surgery on his heart. He turned up for it at 7 am this morning and of the six scheduled booked patients, two arrived. There was a surgical team of ten arranged, who stood around waiting. If this is the normal, and the doctors, surgeons and nurses seemed to think it was, then complaints about underfunding the nhs funding needs should be kicked backed to the public. It's reasonable to expect the treatment paid for via taxation, but it is unreasonable to be so cavalier about non attendance. This was a procedure that cost the NHS £20k or more in salary costs... and two-thirds of the list were no shows. Can you tell that I am incensed for the people on waiting lists and the taxpayers funding the waste? For the record, the roads were all clear.

I recently went for a post-breast cancer mammogram and was seen early because the three people booked ahead of me hadn't shown up. Are they mad?

I was back in the car park and on my way home before my appointment time. Great for me but what a criminally stupid waste of resource.

I think YABU, the train strikes started yesterday and anyone outside London was unable to travel at all due to this. It’s fair enough saying “take the bus” but a one hour journey by train can often translate into a 5-6hr journey by bus. Specialist surgeries like this don’t usually happen at a local hospital. So its no surprise to me really that many missed appointments.

This is definitely YBU
And to be completely frank, I do not think that "mental health" issues should be an easy automatic get out clause.

Only a person who has never been seriously mentally ill would say this. It’s an extremely ableist thing to say and disgusting that you think this really translates to “couldn’t be arsed” from your earlier post and your go to explanation as to why that number couldn’t get to the hospital.

You even mention deprioritising those with mental health conditions and charging them for missed appointments- WTAF? You really have no clue how disabling a mental health condition can be and seem to be just drooling over the chance to kick a person when they are down and unwell.

They may have had their original surgery date postponed numerous times (common) and then received their new appointment date letter after the date of their surgery (not uncommon)

You should be charged for missing appointments you made yourself. But the system of just sending out a letter with a time and date is absolutely useless.
I got a letter about my wisdom teeth removal 2 weeks after the appointment and the dentist refused to refer me again because I missed an appointment.

DSs vaccine letters just don't turn up then he misses them and I get shit .

You should just get a letter saying "call us to book your operation" or a phonecall. It would be cheaper to pay someone to run the phones than to pay a whole surgical team to do nothing.

The people suggesting that DNA'ers are charged for missing appointments..

HOW do you think this will work when the system can't currently cope, and is doing all the things multiple people in this thread have mentioned?

The letters arriving after the appointment date, the letters not arriving at all, appointments cancelled but patient not informed which are still recorded as a DNA, patients cancelling in plenty of time but recorded as a DNA, patients unable to attend as held up elsewhere in the SAME HOSPITAL, having informed the relevant department or asked for them to be informed recorded as DNA...

The list of fuckuppery goes on and on, its not one person, its not one area, it is nationwide, everyone I know, every single person, who even semi-frequently attends hospital or has medical appointments, has experienced at least one of these fuck ups.

So what chance they can run a DNA penalty fee properly, without adding to the burden and cost on the NHS?

Absolutely fucking zero.

Meh, under maternity 'care' I was made loads of appointments I either didn't want, didn't know about or didn't even know what they were for.

Tried to cancel, was told my receptions they "weren't allowed" to cancel appointments.

Another time I called several numbers to cancel an appt because I had covid. They had a phone call asking why I hadn't turned up.

For my post natal check, I declined for myself and just asked for an appointment for baby. Apparently the receptionist wasn't allowed to do that either.

The NHS systems are full of waste. That's what's maddening.

I have to add the time they refused to cancel a post natal appointment I also got a text message from the same surgery saying they were "too busy" to see children ill with suspected strep A.

The NHS is a shit show

From my perspective due to the volume of patients I have to book on a daily basis it's just not a viable option to book by telephone. I book in advance and patients get reminder calls and options to rearrange on a day more convenient (they may have to wait longer if they can only do an afternoon on a Wednesday though for example).

On the odd occasion I have a clinic to fill that's been slotted in last minute and I have no option to book by telephone it takes me four times as long as no bugger answers their bloody phone!

Unfortunately most NHS admin I work with are so stretched there's just not enough hours in the day to complete the work set for them.

Yep. There would be staff time costs for this admin, but they could use the money saved from all the wasted appointments. The NHS is very broken.

My daughter keeps getting DNA letters for ENT, but they haven't sent us out a letter in the first place. It really winds me up, because of course we would attend. One or two times could be seen as bad luck, but this has now happened about 10 times, so there's clearly something wrong with the admin system. Maybe these people haven't actually received a letter in the first place!

Oh, and she doesn't receive reminder texts either, just a letter saying she hasn't attended an appointment.

Yes employing an admin person to call everyone 24 hours before to remind them/slot in last minute replacements would be far cheaper than having a surgical team standing around.

Completely agree. if I'm told my appointment is sometime during a 4 hour window they will usually be running late and call me during hour 5. I imagine lots of people would give up after 4 hours and assume the appointment wasn't happening and get on with their life. That and they often ring once and if you don't answer in time that's it.

It's awful, absolutely - but I would say it's almost impossible to get through to anyone if you do need/want to cancel or rearrange an appointment. I've tried to do this before (just a routine check up in a clinic, not surgery) and the phone just rings out. I tried calling over several days, at different times of day, tried emailing, tried going through switchboard... There should be an easy way for patients to get in touch to notify them, but at least at my hospital, there doesn't seem to be.

You can bet private hospital appointments don't have this problem.
A lot of people see the nhs as a free service and are disrespectful towards it.

See now I had a phone call on a Tuesday asking me if I was doing the prep for a colonoscopy that was due on a Friday - I was like what colonoscopy?? We sent you a letter…the letter arrived a week after the colonoscopy, I had to drive to the department and pick up the prep as they had posted it.

if they hadn’t of called I would have been a DNA

I’ve also had a snotty letter about missing an appointment, the actual appointment arrived 5 days after the I did not attend letter. I was not a happy bunny. I wonder how many other this has happened to.

I’ve also had telephone appointments and then the consultant is either 3 hours early or 3 hours late I’m lucky enough that I have flexibility within my work day and can take the calls.

Sadly the NHS admin side is shocking and out dated.

My waffly point is some DNA are genuine, while other obviously are piss takers…

It is not uncommon at my surgery for someone to ring for an appt, be given one the same day and not turn up.

Plenty of reasons for DNA.

Some will be just people not showing up.

But some will be people who genuinely can't or didn't know:

> letter arrives after the appointment
> patient cancelled but system wasn't updated
> patient tried to cancel but after spending several hours/days trying to get through couldn't (see a number of threads)
> patient hospital transport failed to turn up
> patient has died (and system not updated) or in hospital elsewhere (again, system doesn't always update)

Etc.

It's not always the patients fault.

And what happens to all the people who can’t afford to prepay their operations?

Phone up to cancel it if you think you won't make it?

They need a better booking system. You can't get through to speak to them so you can't cancel so the slot can't be offered to anyone else and all you get are letters which don't always reach you in time!

I was in the kitchen a few months ago and got a phone call - it was a registrar for my phone appointment. I knew nothing about it! The letter turned up 2 days later. If it had been a physical appointment I would have missed it.

Also, if they know there's a very high likelihood people won't show up why don't they overbook surgeries so for every 6 slots book 8 people in (like they overbook flights). They could warn slots 7 and 8 there is a possibility they won't be seen but if so they will go to the top of the list for the next date.

That is fine if people have all the time in the world to hang around hospitals, but I'd be livid if I'd taken time off work and got there to be told they'd overbooked and I may not get seen. Oh and to add insult to injury I'd be expected to take yet more time off work to go to the next one. I suspect most people who work would feel the same

Some of the reasons I'd suspect:

• no money for bus fare
• train strikes
• weather
• having to take time off work (esp. for those on lower salaries)
• appointment letter did not go out/went late
• no choice in appointment day /time (I was told to take the first available one due to short staffing in two different services)
• patient cancelled but message not passed on to team
• patient called to cancel but could not get through/not recorded etc

Yes there are high rates of DNA's for face to face appointments. I don't know what the solution is - or if there is one...

I agree people should turn up but a lot of issues are people getting to the hospital. You normally have to be there at 7am and a lot of hospitals now are miles from where you live. 30 miles my relative had to go for an eye operation. Including a pre op and covid test. Luckily she could get a lift. Wasn't eligible for reduced hospital taxi. A normal taxi was 50.00. Public transport was not really practical with times. If people have no funds or help may be a reason. They should let the hospital know though.