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 guess some of them might have just gone nah can't be arsed but there's loads of reasons for no shows on the day. If you're a carer and your arrangement for the day falls through what do you do?!

We recently got a covid vaccination appointment for my 10 year old, due to their vulnerability it said. But they are not vulnerable, and their vaccinations are up to date. And we were on holiday on the vaccination date too so I phoned to find out more but the phone line was no longer in use - just a recording saying to logon to their nhs account to amend the appointment if it wasn’t suitable. They don’t have an nhs account. I called the GP for advice on how to contact the vaccination centre, but they could only give me the phone number we had already tried.

it was infuriating. I reluctantly gave up in the end and we will have been recorded as a DNA presumably, but it wasn’t for want of trying.

I agree this is a real issue and one that needs addressing urgently. The waste of expensive resources is totally wrong when there is so much unfulfilled demand and funding is under so much pressure.

BUT

What also needs addressing is the way appointments are communicated to patients. I have had three hospital appointments in the last year. One was notified well in advance, one two days prior to the appointment and one the day before.

The two day prior letter arrived on a Saturday and when I tried to ring to change the appointment there was no one available until the Monday (i.e. the day of the appointment)

I have enough flexibility in my week that I was able to attend all the appointments but there are many people who might not be able to get leave at such short notice.

There must also be thousands of appointment letters currently sitting in the mail mountains at the sorting offices. How many DNA’s are caused by letters not arriving?

I am registered with Patient Knows Best but for some reason, that I don’t understand, not all hospital appointments are confirmed that way.

My GP has a reliable way of notifying appointments and sending reminders. The NHS now need a consistent way of notifying hospital appointments and getting confirmation from patients that they will be attending.

One method, one app or website where patients can check appointments and communicate if they need rearranging. Also one which doesn’t rely solely on the Post Office!!

Dementia

Dead of other things

I get all the pro and con messages that some systems work well and others fail, but why aren't the ones that work being adopted and used across the whole NHS?

I received a phone call last week from DS2's consultant's secretary demanding to know why we hadn't turned up for his appointment. We had absolutely no idea he had one! He's usually seen every 6m, so is due an appt in February, but his consultant wanted to run some immune response tests after a recent (thankfully brief) hospital admission. The letter arrived yesterday. Six days after the appointment. The letter was dated two days before the appointment, so even without the postal strikes, we would have been unlikely to receive it in time!

Ive three times this year had appointment letters for my son arrive on the day of or after the supposed appointment. The number on the appointment can’t get through to anyone and no email. So my child is probably in this category. Based on my experience, I’m not so quick to judge the supposedly cavalier people.

Which is why email or SMS would be a better option, perhaps?

This is going to sound flippant, but I wonder if people died waiting.

Or were so ill they couldn't get there.

Or their letters went to addresses where they could not longer reside as they were so sick that they needed to stay with relatives or go into care.

Or Royal Mail have the letters in their mountain of stuff they haven't delivered.

This had crossed mind too. If older frail patients got the appointments, but they are not well enough to organise and remember and their carers are not aware.

This has nothing to do with whether or not they might have died? I had to cancel a few things for dad after he died, and recently one for mum after she was hospitalised.

today I can't help wondering if some were very late due to train strikes and/or snow.

yes, no shows are a problem but I am a bit surprised you're so sure they can't be dead, especially the reasons you've given. You survive one cardiac and all the complications....doesn't make you immortal!

This could easily have been me. I am autistic and the anxiety is crippling sometimes. I could see myself shutting down and missing an appointment. It's never happened but I have had a meltdown in the car park alone and had a passing nurse come to assist me. If she wants there I would not have made the appointment, it was something I had done many times before but that day I just fell apart.

I would imagine there are a fair amount of people who are genuine and people who just cba when it comes to missing these appointment.

The local health authority has an online portal where you as a patient can access digitally both letters and test results. Always kept up to date,

Ds2 almost missed an appointment for an urgent medical procedure in October (not surgery but done under GA). Reason being he was, by that time, an inpatient in the same hospital and had had it done the week before (it went to urgent to critical). I had assumed that the hospital would know this being that he's their patient and all but no, I had to cancel at short notice because their systems don't work like that.

Surely the solution is to write a week before surgery to remind the patient of the procedure, the place, the time, the duration.

I'd actually give a rough cost for non attendance so they know their no show will result in a loss to the nhs. That it's not an invisible cost. I think the nhs can be too polite at times.

Give them a clear cancellation procedure to follow if they want to cancel. Clear phone number to call in bold.

Put on the letter that they will get a friendly call to the number they provided the day before surgery to check they are still ok to attend.

Belt and braces with the nhs in such a dire state.

I’ve received letters three times after the appointment date (telling me on the envelope that a missed appointment will cost the nhs £160). Infuriating. I recently just finished an official complaints procedure where numerous appointment letters were sent to our old address - despite me updating it.

PLUS as a precious poster said, some people are hopeless/thoughtless/incompetent. I look at the lack of reading comprehension skills of parents at my DC school who can’t compute the most basic of letters from school and need to consult the class WhatsApp and they probably wouldn’t be able to follow complex pre op instructions (private school so they need to have the wherewithal to earn enough money to pay the fees - the mind boggles)

For a no show at my NHS dentist you get struck off, we get all our appointments emailed and 2 reminders sent, no excuse to not attend, perhaps that’s the way forward, if DNA, procedure becomes chargeable.

@Panko, what two-thirds of them? Unlikely. Big time. CBA more likely. Will wait for another slot.

That's really what doctors and nurses think.

It's the NHS, it's free. So I'll put it off until it's convenient, or I'll whinge like hell on SM.

It's shocking that people don't show but I do think we need to understand why. In just the last week I've had multiple conflicting messages about my flu and COVID vaccines.

I got a text with a link to book, which I duly did. I got a text the next day with another link saying my previous booking had failed so I needed to book again, which I did, successfully this time and received confirmation. Two hours later I received another text telling me this was my last chance to book an appointment for vaccines. I ignored that text and attended the appointment I'd had confirmed and yet again two hours later received a text telling me I'd missed my appointment.

How many people might accidentally book more than one appointment with such confusing communication but only attend one which would leave the others recorded as no shows?

Undoubtedly there are selfish people who just don't care but it did make me think about inefficiency and waste in NHS systems.

I have notified my GP of the problem.

My experience is that a selection of the general public are hopeless. In part of my role I see and sort patients on 2 week wait suspected cancer pathway. When their tests are requested, they are ALL telephoned by the booking clerks to get them booked in for a test that is within the 2 week guideline AND is convenient for them. All patients are informed that it is a 2 week wait request, so has to be booked within a time frame. This is then followed up with an appointment letter (sent in a taxi if v short notice, to ensure they have it in black and white). They still DNA. They then get another appointment (same process, telephoned, booked in at their convenience back up letter sent) Still DNA. 3 strikes and we discharge. 2 weeks later they're back at the GP with the same issue, and the process starts again - this time we review them in clinic. Explore the issues around attendance, provide support and reassurance re investigations. Patient agrees to test being requested and can you guess what happens?? At least 10-20 slots a week wasted, and that is in one tumour site.

DD and I were a no show for a follow up hospital appointment last week. We hadn’t received the appointment letter. First time that’s happened in treatment that started seven years ago. Fortunately the doctor rang and we could do it by phone instead. Not sure if that was an admin error or postal delays.

My mum has missed two appointments.

First one was for a scan at James Cook hospital. She was in ICU in North Tees and despite me spending well over two hours on the phone, no one at James Cook seemed able to find her appointment so I could cancel it. I had the letter in front of me but they were pretty hopeless.

The second time, she'd been double booked - one appointment at the hospital with her respiratory team and one at the doctors with the asthma nurse. Despite ringing the GP practice multiple times, the line was engaged and she couldn't rearrange it.

Laughs in Psychology 😂😭 Seriously, it is ridiculous. Often there are already measures in place for DNA - phone calls etc. Still no shows/cancellations 10 minutes before or after session due to start. So wasteful and so demoralising

@AutumnCrow bizarrely for my clinics, I have a much higher DNA rate if the appointment is booked via voices - either over the phone or in the flesh. If a letter is sent, it's almost no DNAs.