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’d be okay with that, assuming that the patient had chosen when the appointment was, and if patients got compensated every time the NHS was late for an appointment or messed up administratively. The number of times we’d turn up for an appointment at 9, along with a dozen other people, and then not be seen until midday. Almost as if they think their time is more important than the patients…

This would be a massive problem in maternity care. Given the amount of coercion involved in appointments/tests/treatments. Fining people for not attending puts massive pressure on to attend appointments they don't want. It's unethical.

Also how do you propose this helps NHS admin? Can you imagine the paperwork and appeals and nightmare that trying to find people will have?

@mumoffourminimes you use coercion in an almost positive way. It is negative behaviour and probably explains why some people don't engage with services. My health visitor was coercive. There is no statutory obligation upon a parent to engage with the service. I therefore wrote to the director of the Trust and confirmed I wanted nothing further to do with the hv service and they were never to contact me ever again. Along with a formal complaint that was upheld.

There is no need for coercion if people don't have capacity or there harm being undertaken then a court order is required to take action. Services need to be more honest.

Oh gosh @RosesAndHellebores I absolutely did NOT intend my post to read that way! Maybe I need more coffee before typing.

Coercion is massive problem is maternity care and it's totally UNACCEPTABLE. I have been made appointments I didn't want, I've been told I'm not allowed to cancel them, I've been told the staff aren't allowed to cancel them. Add in fines and it's just another level of coercion and bullying and attempts to control women. Which, for clarity, I'm saying I'm against. It's disgusting and unethical.

Fines are an appalling idea.

A relatives wife told me she had a phone call from the hospital regarding her husband’s missed appointment. He’d died 6 month’s previously, at the same hospital. . I’m sure the mis recording of deaths happens all the time.

I'm concerned anyone might think coercion is a good thing though? Maybe on this thread 🤷‍♀️

Dreadful, that must have been so upsetting for her. I think some posters here would advocate fining a bereaved widow for the crime of having a dead husband.

Rightly or wrongly, some people live chaotic lives and just can't manage to comply with appointments that are arranged on their behalf without anyone checking if that day / time is possible. I think better to accept that and find a work around where possible, rather than demonise them for wasting NHS resources

I've had a couple of tests done in hospital where it was a drop in clinic. Just get referred by GP and rock up any time 9am to 2pm. First come first served. Very efficient. Reduced admin. No wasted appointments. Perhaps that's the way forward, for some procedures. I appreciate not feasible for surgery etc

Another option might be to overbook, in the knowledge that some people don't attend. So, if eg GP knows they have 10 appointments to offer, and likelihood is that 10% of patients don't turn up, could they offer 11 appointments? In other words, factor in the "no shows" rather than acting surprised when people don't attend

the just turn up really doesnt work that well

when our blood test at cottage hospital ran like this, queues were of pensioners at 8am and always had to wait forever. Now they have changed it to pick your appointment time online , working people can pick a more convenient time and you are in and out in 10 minutes.

i was in hospital in april and was told to come back for blood test 2 days later. i was told just turn up, i had to wait 6 hours! 4 hours for the blood test and 2 hours for results , then told to come back next day for a different blood test. I was newly diagnosed diabetic on insulin and needed food, couldnt got cafe incase i was called. i was shaking with low blood sugar by the time they saw me.

@bruffin That's a pity. I was able to go to hospital when it suited me, and I was out 30 mins later

I guess it just illustrates that there isn't a clear solution

I agree chaotic people miss appointments and there is no sense in demonising them. Paying would make zero difference, they would just go without healthcare.

Only if I can start finding the NHS for wasting my time and losing me pay when I arrange time off/childcare etc for an appointment and they cancel appointments booked for over 6 weeks with very short notice ie on the day/day before ; book appointments that are never going to happen (eg booking an appointment on a Tuesday when the consultant only works Mon/Wed/Fri) or just don't tell you that the appointment has been cancelled till you arrive (or look bewildered when you show up as the appt isn't in their schedule despite the fact you have the letter in your hand).

Even if I do turn up to my appointment and it miraculously does exist, I have recieved the letter in a timely manner with all information including time and location being correct and hasn't been cancelled then invariably I end up waiting hours after my appointment time because the clinic is somehow running late despite the apparent prevalence of DNAs ... So I lose more time at work/pay for more childcare because of appointments overrunning with no consequence to the NHS but if I even think about showing up a minute late then they can and will cancel my appointment (even if they're running hours behind).

Additionally I should be able to fine them if they schedule me an appointment that I can't do (I never understand why they make an arbitrary appointment rather than sending a letter telling people to book their own appointment in the schedule like you can do for literally everything else) and then have zero way to cancel/amend/postpone said appointment without spending literal hours on the phone as the number on the letter is never answered or just immediately cuts you off; the clinic phone is never answered; the consultants PA can't/doesn't respond to messages left to confirm they've cancelled the appointment (if you're lucky enough to get a dept with an answerphone option); there is no way to speak to to a relevant person regardless of whether you go direct/through the switchboard etc or have an email to send an email to (so you have a paper trail proof of your cancellation in case they claim you DNAed)

Unfortunately if a fine system worked both ways then, currently, the NHS would be paying out way more to inconvenienced patients than they made from the minority of DNAs caused by people who genuinely couldn't be arsed turning up.

@melj1213

👏

I'm 53 and have missed 2 appointments in my life - first one was for ear syringing and I was in hospital in labour with DS1 at the time so didn't feel too guilty. Second one I'd made an appointment at one surgery but thought it was another however when I turned up at the wrong surgery I found out I was also 24 hours too late! Felt so bad that I was now part of the statistic on the desk which showed how many appointments were missed. Id even had a text message back up!!! There was no excuse other than a genuine mistake but I still feel SO guilty. I do get mildly annoyed however on the rare occasions I DO make a doctors appointment, arrive 5 minutes early but am kept waiting for a long time. The last appointment I had was for 8am and I didn't see the GP until 0842 and this was pre-Covid.
I had an appointment to give blood earlier this month - the last 3 times I've turned up half an hour early and gone in half an hour late - no big deal. This time I got stuck in traffic, the road was blocked by a tipper truck and I arrived 15 minutes late. They said I was too late and would have to come back another day.

Fining me would just make me spiral. The fear of a fine would just add to my pre appointment spiralling that I already go through just to get to the clinic in the first place.

Suggesting fining DNAs shows me that you don't understand the many complex reasons, already explained at length on this thread by many many people, why people fail to attend their appointments.

This isn't aimed at you @antelopevalley I'm just piggybacking off your comment.

I missed two appointments when seriously ill. One I never received a letter. The second I had multiple appointments and lost track and just forgot. I also cancelled an appointment and received a phone call on the day asking where I was.

So I have officially DNA three appointments but only one was my fault. Charging would have made zero difference to my personal DNA rates.

Shocking and unacceptable. However, the last time I had day surgery with a GA I was assured by a liaison manager (not medical staff, but someone whose job was specifically to coordinate such things) that I would absolutely definitely be ready to leave by x time. I don't have a partner or local family so had roped in a friend to come and meet me. This friend was free until about three hours after my latest possible release time, after which he had to go to work. Well surprise, surprise the procedure was delayed and delayed until my friend could no longer be available. Apparently the promise of when I could leave should never have been made in the first place.

I had exactly the same thing when my husband died.

He’d even have the situation several times when needing an in-patient slot for several reasons, each department would book conflicting appointments. And not be in the slightest bit interested in sorting in out.

The whole appointment system is run for the benefit of the staff/hospital, not the patient. Appointments are sent out as if by royal decree - please attend x location at y time, with a whole threatening spiel about the cost of non attendance. That’s not how dentists operate, or any other service. The customer books an appointment that’s convenient for them, and guess what, they then feel a bit more responsibility and ownership for it. None of it needs to be as complicated as it is…

So many people think that because the NHS is "free" (they don't understand this means it's paid for by general taxation) that it doesn't matter if they miss appointments because it isn't them paying. Basically they have no understanding or respect for other peoples time and money.

I think everyone should contribute something towards the NHS (even if it is a small token deposit for appointments which are refunded upon completion of appointment or cancelled 24 hours in advance) so that they value and appreciate it a bit more. So many people take the piss at the moment.

The health care system in my hom ecountry worked on this drop-in basis up until recently. It often ment sitting and waiting around for hours, usually at a specialist doctor. GPs usually shorter. Some now have a combination of drop-in times and scheduled appointments. But the time is agreed and arranged in person or over the phone, or in a special online application/form where you pick a slot.

I think everyone should contribute something towards the NHS

Sort of like a tax?

If they had to pay, they'd definitely turn up...

Unless they have some form of cognitive impairment such as dementia, learning disabilities or mental health issues that prevented them from attending. Not everyone with cognition issues has support to help them with attending appointments.

OP, you seem to know an awful lot of detail about this ........... hmmmmm 🤔

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