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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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

459 replies

XingMing · 13/12/2022 21:51

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.

OP posts:
alloalloallo · 14/12/2022 14:05

My daughter has had some health issues this year so we have had a number of appointments with different departments within different hospitals.

Nearly every appointment has had some kind of issue - appointment letters sent after the appointment date, letters taking forever to arrive so not received in time, appointments I’ve called to cancel not being cancelled on their systems, we’ve turned up to appointments to find the consultant doesn’t work that day, turned up to appointments and found no record of it on the consultant’s systems.

She had to have a 24 hour EEG, so 2 appointments 24 hours apart. The appointment they gave us fell on a GCSE exam day so I called to cancel, they made me new appointments a week later. Went for the EEG, and then a few weeks later I get a DNA letter for the 1st 2 appointments.

I’ve made contact with the various consultant’s secretaries and they’re kind enough to email me now - they say themselves that their admin is completely screwed up and are about 8 weeks behind at the moment so letters aren’t making it out on time, if at all (weird how the DNA ones seem to get sent promptly though). We’ve been waiting nearly 8 weeks for a diagnosis letter to arrive

Of course, there are DNAs when people just don’t bother/forget, but at the same time there are huge issues with admin systems.

MrsFinkelstein · 14/12/2022 14:06

pigsducksandchickens · 14/12/2022 13:36

This! Why can't they text you - my dentist does a few days before. Not exactly rocket science!

My local NHS Trust do, but it's obviously not a national norm.

Then again, not everyone gives permission for that.

antelopevalley · 14/12/2022 14:08

There would have been no point texting appointments to my dad. He only turned his mobile phone on when he wanted to make a call. That was arrely.

Badbadbunny · 14/12/2022 14:18

Just to echo the experiences of others on here. My OH has cancer and has needed numerous appointments for various tests, scans, x-rays, chemotherapy sessions, etc. Appointment administration is pathetic. You get a random letter through for some things, phone calls and/or texts for others - just no standardisation, not even from the same hospital.

When you phone to change an appointment, which happens a lot because he has to have a blood test x days before each chemo session and the dept are incapable of organising that properly, so every month, OH has to phone to change the appointments they sent him, so that they match up properly. Usually, no answer to the phone number given, just an answerphone which they never call back from, so he has to keep trying at random times of the day and eventually gets a human. Often, they can't change the appointment and just glibly tell him to phone to change the other appointment, then he tells them it's the same number on the appointment letter, so it's definitely their dept to change one or both to match properly.

He also has a monthly phone call from the haematology consultant. Should be the day before issue of the sack of drugs he has to collect. But of course, the letter comes through with all kinds of random dates which don't match, so he has to phone a different dept to get them to make the consultant phone call on the right day (usually takes several attempts).

The whole NHS admin is a complete shambles and must cause massive amounts of waste, wasted appointments, etc., just be incompetence and inefficiency!

cptartapp · 14/12/2022 14:33

Purplechicken207 · 13/12/2022 22:09

No idea how it could possibly be feasible, but there should be a DNA fee, or if you miss 2 in a reasonable timeframe you waive the right to free treatment for a year. Of course that assumes robust systems to communicate appointments, and probably some exceptions like extreme weather, severe unexpected traffic disruption etc, but personally I've never had a problem. Text upon booking (letter too if for child/antenatal/hospital), text the day before (assuming not an on-the-day appointment). I did miss 1 health visitor appointment shortly after baby was born - sleep deprived, post c-section and they'd booked me one outside of my own home (usually at home for first couple weeks, especially post section) the other side of the nearby city. I wasn't able to drive (or lift baby in car seat) due to the recent section and husband was back at work, didn't realise til time of 🤷‍♀️

Would that fee apply to everyone, of every age and circumstance? Or would it exempt the usual groups regardless - pensioners, children, those on benefits, penalising the poor sods in the middle yet again.

RosesAndHellebores · 14/12/2022 14:34

I am pretty sure that the root of the problem lies in the fact that people who work in the NHS have zero respect for the time of their patients. They actually believe they are the only professionals or workers with any relevance and the public or the patients shoukd shower them with gratitude for what is too often poor care and poor service.

I am so glad we didn't clap. In fact none of the houses in our road did and three are populated by medics.

antelopevalley · 14/12/2022 14:39

@RosesAndHellebores Nope. They know admin in the NHS has been cut so much it is a mess and know there is no political will to sort it. Because saying we are going to recruit 3,000 more admin workers does not get the votes that saying we are going to recruit 3,000 more nurses has.
And people bought into the lie that admin does not matter.

latetothefisting · 14/12/2022 14:40

Dragonskin · 14/12/2022 08:04

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

Really? I wouldn't (feel the same that is). Presuming it's important surgery, not a jolly id do anything to get seen sooner. Key to the idea is they would obviously tell the reserve people that they were reserve and it would be voluntary, so they wouldn't be expecting surgery and then going home disappointed but would know from the start they might not get seen - and if they didn't their next date would be definite.

You would need to have 1 day off work anyway, and if it was like ops example the surgery team would know early on whether the original appointees had turned up or not so the reserve people wouldn't be hanging around for hours not knowing.

I dont think you can make overall judgements about "people who work" anymore. So many people are semi-retired or work remotely and flexibly now - for me the inconvenience of making myself available for a few hours would be very minimal given the potential benefit so I wouldn't think twice about volunteering.

Obviously it wouldn't work for everyone or be completely fair for those who can't easily amend their working hours, dont live nearby, sort childcare or take time off, but no systems are equally fair for everyone - even if only a few people could be in the position to jump in last minute or wait around as a reserve that still makes the overall waiting times shorter for everyone and is better than appointments being completely wasted?

RosesAndHellebores · 14/12/2022 14:41

@cptartapp the blanket exemptions irritate me hugely. DH and I are both over 60. We both now get free prescriptions. We are both still working full-time (I've just broken off for a sandwich). We both earn high salaries. Notwithstanding the fact that I've had free prescriptions since I was 29 due to needing levothyroxine. For heavens' sake I didn't need three everything else.

Paradoxically due to undiagnosed graves for too long prior to becoming hypothyroid I am pretty sure contributed greatly to my severe osteoporosis. 5 breaks in five years. Two bad ones subsequent ton zolendronate. The optimal treatment is with teriparatide. According to NICE I don't meet the bar. I find it extraordinary how NICE provides guidance that doesn't have to be followed when it saves money but it has to be followed to the letter when there is a cost attached. Currently paying £1,250 per year personally. It will keep me working and contributing.

The system is a complete ass.

RosesAndHellebores · 14/12/2022 14:53

@antelopevalley serious question. Why is more admin needed instead of modernisation? My GP surgery seems to have more receptionists, administrators, practice manager, assistant practice manager, than they do Dr's and nurses. I do wonder what the chuff some of them do because it doesn't seem to extend to answering the phone or attaching the correct reports to referrals or even dealing effectively with repeats. In the 60s we had a 2 GP practice. No receptionists. People just queued up and the Dr finished when everyone had been seen. Nice Dr had a long queue; grumpy Dr a short one. We always saw grumpy Dr and my mother made sure we arrived 20 minutes before the star of surgery so there were only two people ahead of us. The system seemed more respectful and more efficient too.

Mycatsgoldtooth · 14/12/2022 14:55

I missed a scan due to not getting a letter or notification. Just a call to say I’d missed it and now would have to go the the back of the waiting list.

alloalloallo · 14/12/2022 14:57

antelopevalley · 14/12/2022 14:39

@RosesAndHellebores Nope. They know admin in the NHS has been cut so much it is a mess and know there is no political will to sort it. Because saying we are going to recruit 3,000 more admin workers does not get the votes that saying we are going to recruit 3,000 more nurses has.
And people bought into the lie that admin does not matter.

Especially when you can blame the ‘feckless’ public for wasting ££££££ for not bothering to turn up for appointments.

JaggySplinter · 14/12/2022 14:58

You're not alone in the rage you fee about this. My now ex H DNA a surgical procedure because he decided on the day that the timing wasn't convenient for work any more. It was a turning point in my marriage to be honest. I couldn't imagine the selfishness or how he could honestly think what he did was ok. But he really didn't see my perspective at all.

antelopevalley · 14/12/2022 14:59

@RosesAndHellebores In the seventies my GP practice had receptionists.
They do lots of admin work. So you see the GP or consultant and they say you need tests for x, y and z. Most hospital Drs, and certainly on A and E, record on a voice recorder the tests that need to be ordered and dictate letters. Admin book tests, tell the patient when and where they are happening, write to the GP to keep them updated, including about the consultants diagnosis, and updates medical records. That can be from an 8 minute appointment with a Consultant. When you arrive to see someone for that 8 minute appointment, a referral will have been made so needs to be read and an appointment booked, you need to be informed about it, and then you go to reception to tell them you have turned up. There is a lot of admin if things are going to run properly.

antelopevalley · 14/12/2022 15:00

alloalloallo · 14/12/2022 14:57

Especially when you can blame the ‘feckless’ public for wasting ££££££ for not bothering to turn up for appointments.

Agreed. The tactic is always to blame the public. Always.

AutumnCrow · 14/12/2022 15:17

I reckon that politically it could be sold that '3,000 more ward clerks are to be recruited to make sure that every patient gets to their appointment on time, ready and prepped, to save the NHS money and shorten waiting lists'.

Call them something old-fashioned like 'ward clerks' or 'traditional doctor's secretaries'. Like bringing back matrons. Anything to (a) improve things, and (b) get the Daily bloody Mail to not rubbish it out of hand.

However, the research needs to be used to pinpoint exactly where these people are needed and for what precise purpose. And for god's sake don't call them 'patient journey facilitators'. Just don't.

Florenz · 14/12/2022 15:28

The NHS needs to get their house in order. It shouldn't even be possible to send someone appointment info with the wrong address on it.

Marigoldandivy · 14/12/2022 16:22

I attended an outpatients department last week and there was a sign saying that there had been over 300 missed appointments in the previous month. Even allowing for administrative mistakes and genuine reasons for not attending and not cancelling, that is staggering. I only had my appointment because there was a cancellation, and had been waiting since March. It is pretty irresponsible in my opinion.

XingMing · 14/12/2022 16:54

I'm delighted that the majority agree that it's shocking to waste costly NHS resources so wantonly. I also hear the caveats about how and why admin processes can be cocked up completely by the post, and the difficulties of getting through to cancel impossible or unnecessary appointments.

And yes, councils should have been gritting pavements to avoid slips, trips and broken bones to protect the NHS.

Heaven knows what the solutions are. It's not all about more money, as the Times wrote this morning, although it might help in some areas. Winter is always tough in hospitals; some people and hospitals are better organised than others. IT seems to be a problem across the entire NHS, yet some of the high-tech procedures are dizzying.

I wouldn't always have been so bothered but my experiences over the last 18 months have made me both grateful and critical, and now I discover myself outraged on the NHS's behalf too.

OP posts:
antelopevalley · 14/12/2022 17:18

@AutumnCrow You may be right.

2bazookas · 14/12/2022 17:45

I'm sure you're well aware that all patients had to be as well as possible for the best outcome of surgery and general anaesthesia ; normal temperature, no symptoms of infectious diseases like flu or covid.

It's winter, prime time for colds and flu which can affect breathing heart rate etc. There are major transport difficulties atm. Some of those patients may be far away.

Lucky DH that he is well enough for his operation and able to get to the hospital safely.

Moonatics · 14/12/2022 19:11

WiddlinDiddlin · 14/12/2022 04:58

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.

Absolutely.
I have my first ever DNA last week.
My gp organised physio for me, he was adamant it would be an initial phone consult. Then from the call they would decide about inviting me in.
No phone call, because apparently I was supposed to go to (where I dont know because phone call doesnt need an address) the place to be investigated for my needs.

No letter, no text, no reminders at all which may have given me a clue that what I was expecting wasnt right.

That's just one reason why charging would be futile, unless the plan is to charge literally everyone and send all reminders on the day so everyone gets them too late and is charged. As a money making scheme, it has merit.

Add all the other reasons for people missing appointments (the eye clinic letter is particularly obstructive) it's amazing so many in fact make it to appointments.

XingMing · 14/12/2022 19:32

capx.co/without-reform-the-nhs-will-never-have-enough-staff/?utm_source=newsletter&utm_medium=email&utm_campaign=14%2F12%2F2022+

The above is a link to an opinion about NHS productivity and staffing that covers some of the territory this thread has explored, including the shortcomings of appointment admin that was published today. It's not a very long read, so some people may find it interesting.

OP posts:
antelopevalley · 14/12/2022 19:43

Except the reform the NHS needs is to be funded properly.
People forget in 2010 it was judged to be the best health service in the world.

thenightsky · 14/12/2022 19:55

AutumnCrow · 14/12/2022 15:17

I reckon that politically it could be sold that '3,000 more ward clerks are to be recruited to make sure that every patient gets to their appointment on time, ready and prepped, to save the NHS money and shorten waiting lists'.

Call them something old-fashioned like 'ward clerks' or 'traditional doctor's secretaries'. Like bringing back matrons. Anything to (a) improve things, and (b) get the Daily bloody Mail to not rubbish it out of hand.

However, the research needs to be used to pinpoint exactly where these people are needed and for what precise purpose. And for god's sake don't call them 'patient journey facilitators'. Just don't.

We used to have people who only dealt with appointments. They sat in clinics and rebooked follow up appointments with each patient as they left their appointment, thereby giving them an actual choice of date and time.

They were called Appointments Clerks (unsurprisingly). They took all the cancellation calls too and worked Saturdays running off the next week's lists, pulling the casenotes etc.

As these people retired or left for better paying work, they were never replaced and their work was outsourced to faceless companies who don't give a shit about patient care.