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.

@antelopevalley I'm certain the NHS needs enough money to cope with an increasingly elderly population, but there needs to be more attention to social care alongside the NHS. I spent most days in October visiting my late DMIL in a huge acute care hospital's orthopaedic trauma ward, spent in the highest-need bay with six beds occupied by very old women in varying states of physical frailty and dementia. Two doctors told us that it wasn't the right environment for her to get any better (not that she wanted to) and that a gentler recovery nursing care ward a step above the capability of her (excellent, self-funded) care home would have been better, but that such a place no longer exists.

I agree @XingMing - we need to get the cottage style hospitals back to support getting people out of acute settings and into a step down facility prior to them being able to go to their long term setting (whether that's home or into a care facility etc).

I doubt that will happen though as they've sold off all those hospitals / land and it would cost far too much to get back to that sadly (& that's before you even get onto the point about wages for nurses!).

It needs proper funding and proper management as there are also too many senior managers, along with too many initiatives that don't support the staff or patients but which cost a fortune!

Oh I don’t know there are tons of empty retail centres that could be converted.

From the icy pavements thread

musicandpassion · Today 10:33
It's not unreasonable at all. It's dangerous and the paths aren't cleared even nearly enough. I'm going out today to get some grit for my drive and the end of our street.
I work in an NHS hospital and we have about 15-20 patients with fractured neck of femurs waiting to be fixed. We are cancelling elective operations to get these patients done but we're also struggling for beds for them to go to after they've been to theatre. Stay safe

*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?*

Yes really, because that is not an insignificant list of circumstances that taking a day off 'just in case' you get seen doesn't work

Of course taking a day off for surgery isn't an issue (plus planning recovery time etc), taking a day off/rearranging everything and then finding out you aren't actually getting this long awaited surgery and will need to reorganise everything yet again pissing off work/calling in more favours for childcare and transport is not.

As you say it would only work if people volunteered to be 'on standby' and they gave people the chance to opt out of it

Personally my experience of the NHS is that they couldn't organise a piss up in a brewery so I wouldn't hold out hope either way

No idea, that's why I said I don't know how it would work. I'm in that middle bit too (and consider my children appointments to be my responsibility too). Of course many pensioners don't use text alerts and email, so there would need to be a robust system to give people every opportunity. And let's face it, the NHS could say 'you owe us £20' until blue in the face, unless they can easily enforce it, it means nothing. So it's all just hypothetical and would never happen. Just so annoying that we pay tax for a health system (which lets face it hasn't been properly funded for a good decade or in some cases managed properly) and people don't bother turning up. I'd be mortified if it is was me (though I wasn't for the one I missed as who the hell would expect a new section mum could drive to a postnatal appointment 40 mins away, especially when the expectation is that they're usually all home visits)

Perhaps the DNAs had tested positive for covid?

@RunAwayTurnAwayRunAwayTurnAway poor excuse, I'd have at least called to cancel the appointment, or emailed if I couldn't get through on the phone. At least then it would be classed a cancellation as opposed to DNA and it could give someone else the chance to be booked in, or staff to be deployed elsewhere for that day.

Wholeheartedly agree that people should attend schedules appointments, but my dm experienced the opposite. She was called with a last min cancellation appointment. I had to take a day off work unpaid to attend with herbut didn’t mind as I wanted my dm to be seen as soon as possible. Got there and no one knew anything about the appointment. We were there for an hour while the lovely lady on reception tried to resolve the issue to no avail. We arrived home to a phone call telling us that the person who arranged the appointment had forgotten to book it in on the system and we could return the next week. Fine but I had to take another day off work and my dm had to wait longer for her diagnosis. It wasn’t good and she was dead by the end of the week.

This was an extreme consequence but it wasn’t the first time we had attended nonexistent appointments (and had an apology because of an organisational cock up). I may have some sympathy if the hospitals could manage to resolve their own issues. As it stands they are pissing away public money through incompetence and I think the whole system should be overhauled. My experience isn’t of a system struggling as a result of non attendance by the public, it’s of a thoroughly incompetent system that doesn’t know it’s arse from its elbow.

Some Trusts have a DNA policy, i.e. three DNA's equals a discharge. Sadly, the Trust I work for don't have anything like this and people take advantage.

Surely most people have email and cell phones or at least landlines? Does the NHS never use these? (Genuine question as I am based in the US these days.) My doctors are relentless about reminding me multiple times in all 3 ways so that it would be literally impossible not to know about the appointment - I think it's all automated as well. Much as I hate the US care system it does seem that it's better organized than relying on traditional post to reach people.

Nope they don't.

Apparently some trusts do, but where I live they send you a letter in the post with a random date and time on it, and that is it. If you are lucky you 1) get the letter 2) get the letter before the actual appointment date 3) can actually make it. Honestly it is the most ridiculous system. I am very jealous of people that get texts and can see future appointments on the NHS app because neither seem to be the case where I am

To be honest, because it is such a nightmare I use private healthcare where I can (including GP services) because you then do get a say in the convenience of appointment, can get an appointment without waiting for ages and get sent reminders

Of course it wouldn't. Provision can be, and already is, arranged for that.

I spent 17 years working in an out patient clinic and you'd be surprised at who DNAs.
It is hardly ever the elderly and is quite often people who consider themselves too busy.
It works in other countries and something has to change here.
People are just not understanding that there is not the slack in the system to pander to this.
I have sympathy for the OP, sounds like the unit involved is badly managed.

I find it shocking. I have always considered this system of allocating appointments and informing people about them via a letter is weird.

System I am used to is you organise and appointment yourself either in person at the specialist's office or via phone. a GP give you written referal letter if you need one.

Does it though, if they don’t have someone advocating for them? I’ve already given the example of my mum dropping out of regular GP care/monitoring because she couldn’t cope with making the appointments and no one noticed it or arranged for any follow up.

she’s got a lovely GP who remembers her when we go but I’m sure that the minute we leave her surgery mum is forgotten. There’s no regular review of notes or flagging that she hasn’t requested repeat prescriptions so can’t have been taking her medication. You have to actively present yourself to get noticed.

Provision should be arranged for that.

Its nowhere near as simple as that at the moment. Like many areas that one is problematic and it absolutely would mean people with cognitive and memory problems would miss out on care.

I completely agree with this. I've lost count of the amount of times in the last six or seven years, that myself or DH or my daughter or her partner have had to change appointments that have been allocated for them because we're at work. And quite often there's no way to get the time off because sometimes the appointments are the following week! Or just a few weeks later.

DH used to do funny/odd shifts, and 2 out of 3 times he would be on shift when an allocated appointment was made!!! So he'd book the time off, or just have it off and lose the money, and the bloody appointment was cancelled the day before. There was no way he could cancel the 'leave' or say 'I want that shift now, as someone else had been given the shift. Happened sooooo often that it became exasperating and infuriating. Do people not realise they're messing with people lives and livelihoods here?! He lost 100s of pounds a year in cancelled and re-arranged appointments. They go on about what the NHS loses with patients not turning up, but what about the other other side of the coin, the 1000s of patients who lose money from their appointment being cancelled and postponed left right and centre?!

The some specialist actuator only do Wednesdays. Just four days in every month. So if you can't make any of those Wednesdays, your Scrooge could be waiting an extra month or two for your appointment.

One consulted that cousin of my manager for five years ago, only worked every second Thursday. So God forbid if you couldn't make it on one of those two days in every month that he was on. Absolutely fantastical.

Posted too soon! And my last 2 paragraphs went batshit! SHOULD have read...

This one specialist actually only does Wednesdays. Just four days in every month. So if you can't make any of those Wednesdays, you're SCREWED. You could be waiting an extra month or two for your appointment.

One consultant that a cousin of mine went to (five years ago,) only worked every second Thursday. So God forbid if you couldn't make it on one of those two days in every month that he was on. Absolutely farcical!

Unfortunately there are many examples on threads like these where people have not been able to cancel appointments (phones rang out, and never picked up; or answerphone messages were not listened to) or they have cancelled but it still shows up as a 'DNA' because information is being lost within the NHS system which is not the patient's fault.

Im getting really tired of the patient blaming rhetoric on here. Its the same as the tenant blaming rhetoric practised by housing associations.

I got a text notification of a new hospital letter on line today. Looked at the letter, dated today, advising me that I would have a telephone appointment last week. Fortunately I had answered my phone on the day in question. I don't usually answer unknown numbers, but I had sent a Px request to my GP and thought it might be them.
I was surprised that it was a doctor from the hospital and tbh, the conversation would have gone better if I had known it was going to happen. I am usually quite organised and get my diary and recent paperwork ready. Plus a notebook and pen ready. Oh well. Presumably if I had missed or not answered the call that would have been a DNA.

Good luck with that.

when my DD tested positive - tested as per the hospital’s request - we rang the number on the letter over 100 across the day and next morning. We tried the hospital switchboard, her consultants Secretary and everyone we could think of. The dept in question just never answered the phone.

That is not uncommon. DD has another appointment coming up where I’ve been sent contradictory information about fasting and medication before she goes in. So far I’ve made 82 calls and sent 12 emails since the letter arrived. I’ve not had a single call answered or email reply yet.

It really isn't.

Shocking! They should be fined for not attending