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.

@FlissyPaps It would cost a fortune to provide paid support to everyone with cognitive issues. Cognitive issues are very common with lots of serious physical illnesses or treatment.

Another great post.

all the computerisation has caused havoc for people who were able to manage when they could talk to humans.

The current triage systems benefit the sharp-elbowed middle aged pushy people like me who insist on getting what they need from the system, a lot of older/less pushy/cognitively impaired/hard of hearing people can't do that.

Oh tell me about it! I've had appointments about things that seemed very serious and scary, but the letter was very sparse and left me very worried about what would happen on the day. I needed way more detail than they'd provided, to set my mind at rest, because I was really nervous about the whole thing. I had to be very active in phoning the department and perservering in getting to speak to someone to ask them some questions. I'm very motivated and I'm the sort of person who'd perservere with these things, and I've also had to put a lot of pressure on PALS on a couple of occasions. But I'm sure a lot of people out there just wouldn't have the energy or time to do so, and would end up chickening out and not attending. The way to avoid those DNAs would be to send much better leaflets about the procedure, detailing exactly what would happen on the day and what the timetable would be etc.

There's also a huge issue in trying to get through if you can't make your appointment -I was on the phone for over half an hour the other week just trying to get through to cancel a completely routine physio check up with several days notice. I was so tempted to just not up. They don't provide any sort of email contact so the only option is to ring yet nobody answers the phone. Why stuff like this can't be automated in 2022 is ridiculous.

If people can actually get through to cancel you could move people up from the wait list.

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. Or just have a waiting list of people who are prepared to get there last minute. It would even be cheaper to pay for hotels or whatever overnight for the "reserve" people than pay staff to do nothing!

No one who uses mental health reasons as a "get out clause" feels good about it.
Do you think they just use the date for their procedure to come round, and they shrug and get on with their day?
If you are having a procedure that might end up telling you that you have something really bad, then if you have bad health anxiety already, you might not show up to the appointment.
If you are anxious about the procedure itself, the build up to it can make you so stressed, you feel very sick. You can literally freeze and not be able to move to get there.
There was a thread here recently about a mum struggling to get her DS to the dentist. She literally had to spring the appointment on him to get him to go. If he hid in his bedroom an hour before the appointment and refused to come out, then he would be DNA too.
I have gone DNA (I am better nowadays though.. I try to cancel) for simple things that involve needles. I have a crippling phobia. It takes a huge amount of effort to get to any appointment.

OP, going to sleep as I have been up since 5.00 am to get DH to the clinic that prompted this thread. Bookmarking and will read new posts in the morning. Night night, sleep well

There are so many reasons why people might DNA and only a small minority will be people who CBA, a lot is down to NHS admin and lack of communication and continuity of care. Letters not being sent out on time or with exceptionally short notice (post marked less than 48hrs before the appointment); letters getting lost in the post (especially atm with postal strikes); no transport (cancelled public transport due to strikes/weather; lifts just not turning up etc); emergencies with children/family that take precedence (once missed a physio appointment because DD had had an accident at school and I was in A&E with her and I'd totally forgotten to call them); no or limited ways to cancel appointments (the phone just rings out and there's no way to even leave a message, if there's a contact number at all, or there's only someone in the booking office Monday and Tuesday so if you get a letter on Wednesday for a Monday appointment there is literally no way to cancel); messages not being passed on; different departments in the same hospital sending out appointments for the same time or overrunning (I once had 2 appointments in two different departments in the same hospital about 3hrs apart, I DNAed the second one because the first clinic was so behind I was called in for my 1st appointment 10 mins before I was supposed to be at the 2nd, and nobody answered when I tried to call the 2nd clinic reception when it was clear I wouldn't make both appts); patients being taken into hospital for another medical issue and informing their doctor of an existing appointment and then not passing on the message (happened to my great uncle a few weeks ago - was due to see rheumatology on a Tuesday afternoon but fell and broke his arm at work on Monday morning. It needed pins so they operated Monday afternoon and kept him on a ward. He explained he had an appointment on Tuesday afternoon and they promised they would inform the other dept that he was an inpatient. 2 weeks later he got a discharge letter from rheumatology for DNAing and he had to go through a whole string of phone calls and send them an email with his orthopedic discharge papers before they would accept that he had a valid reason for not attending and added him back to their list)

I had surgery in April this year ... And there were so many places where communication was lacking due to the non joined up nature of the NHS systems. It should have happened in January but due to another health issue it was postponed to March. In March, on the day of surgery it was cancelled (due to theatre staff having COVID they cancelled anything except emergency procedures due to staffing levels) and postponed till April.

Firstly for each surgery date I had to do a 2 week COVID isolation at home to make sure I didn't have it before my surgery ... For my January 19th surgery they called me on January 3rd to say my surgery date was the 19th and I needed to go into isolation as of the 5th. I work in retail so fortunately January is a pretty quiet month but even so it was massively short notice (I had told my boss that I was having surgery and knew it would be the start of the year, but not exactly when, but I expected I'd get more than 2 days notice).

When it was cancelled the first time I asked them to give me more notice for the second one ... Same thing happened, got a call on Friday saying I had to go into isolation from Monday ... two weeks later it ironically was cancelled due to staff having COVID. By the 3rd date at the end of April I knew I would t have much notice and again was told 4 days before I had to go into isolation, only to get to the hospital on the day to be told "Oh you don't have to do 2weeks now, just 48hrs from your COVID test ... did nobody tell you they'd changed things at the start of April?"

For each surgery date I had to arrange for the District Nurse to come 15 days after surgery to remove my staples as it apparently couldn't be done by my GPs practice nurse (Op was done at a hospital 3hrs away so not practical to return just for a few staples to be removed). Because the op was done in a different NHS trust they couldn't liase directly with the DN so I had to call them and leave a message saying when my op was and when I would need to see them but since they are only in the office Tuesday and Thursday 9-11am it took over a week for them to get back to me and confirm the appointment to come and visit me.

When the first two dates were cancelled I left multiple messages on the phone and email saying my surgery had been postponed and therefore no longer needed the appointment (both with at least a weeks notice) and could someone call me to confirm they had received the messages. Both times I had a DN turn up at my house on the appointment day and then act annoyed that I hadn't cancelled despite the evidence I had of calling/emailing to cancel.

My favourite miscommunication though was that after surgery I have follow up calls with the surgeon booked for 3 weeks post op, 6weeks post op, 12 weeks post op and then every three months for the first year. When I recieved the email with my surgery date (following the late notice phone call) I also received the dates for my follow ups. When my first two ops were postponed I asked if they were going to cancel my post op appointments and they said they would automatically be cancelled. I still recieved reminder texts and emails for each one and then messages saying I had DNAed so I had to call the office each time to be told "Oh sorry it's still in the system, I've sorted it so it won't happen again" (reader, it happened again and again and again). For my 3rd date I was booked in at the end of April which was 12 weeks after my original date. I'm day 2 post op and lying in my hospital bed when my phone rings so I answer it only to hear my surgeon introducing himself on the other end.

When I ask why he's calling me, considering that I'd seen him only an hour previously on his rounds, he was utterly confused as he was calling his January patients for their 3month follow up and he apologised as he assumed my file had got mixed up on his desk. Somehow my name was still on his January surgery list despite the fact I was physically in the hospital and he had operated on me less than 48hrs previously!

There are so many ways that things can be mismanaged when everyone on a supposedly National service cannot fully access all the information they need, and patients are blamed for things outside their control.

But you are continuing to be cross at the minority of just shit people who don't care, when you've been told there are a lot of systemic reasons why people don't attend.

Equally, we attend on time, but don't get the NHS service because it's late or not happening. We've had four hospital appointments in the past two weeks (unlucky). One happened, but the consultant wasn't there, no idea why so no decision could be taken without him so fairly pointless to go. One was a telephone appointment with CAMHS and they never phoned, no idea why. I know their whole database packed in about 6 months ago, so they don't know who has appointments. One was a clinic, the appointment was one hour and 30 minutes late. One happened within ten minutes and was what was promised. So one out of four happened within a reasonable timescale and was what was supposed to occur. It is not just patients who are not there and not on time (not that I blame the individual staff, I blame the whole NHS underfunding!)

The system is creaking. In a creaky system, the poor (depending on public transport, lifts, hospital transport), the elderly, the disabled, the mentally ill all lose out because they struggle with the system. Blaming a few individuals who don't care (and for sure they exist) is not entirely fair at all.

I tried to cancel an appointment but couldn't get through despite numerous attempts. I couldn't go as it was scheduled for the day of my best friends funeral so not something trivial.

We were waiting around for a patient the other week. Phoned them to see where they were. They'd had a phone call the night before to tell them it was postponed. No one thought to tell us or the theatre team!

Have a good sleep! Good night.

I used to live in the arse end of nowhere. Post arrived (Royal Mail) maybe twice a week. Twice I received an appointment letter I was waiting for after the appointment date. I phoned the secretary, twice, who didn't believe me, and who threatened to cancel my referral. I emailed my GP, saying I was not refusing to attend. Third appointment letter was by some miracle receivedl the same day but for a time less than an hour for more than an hours travel to the hospital.
I went, and they didn't see me. Paid private in the end.
Shambles.

I was sat in an allergy clinic a few months ago and the receptionist was ringing the next weeks appointments to confirm attendance - I heard her speak to 6 people of those 2 weren't intending to turn up but hadn't cancelled the appointment. She was asking for reasons but obv I couldn't hear those. It's maddening that people are waiting and people just can't be bothered - I get they might not want the appointment but they could have cancelled so someone else could take it.

My daughter needed an urgent MRI 2 years ago. We only made the appointment because I happened to call up chasing the appointment the day before the scheduled appointment and they told me when it was over the phone. The appointment letter came through the week after the scan.

DD recently needed a follow-up appointment after a hospital stay. Received letter with details, 2 weeks ahead of the appointment. Letter stated video appointment - do NOT (in bold capitals!) attend the hospital. Received 4 reminder texts over the next 2 weeks all stating video consultation do not attend hospital. Letter said we would be sent link to log in 1 hour before the appointment time.

Day of appointment, rushed out of work to pick DD up from school at lunchtime, set up laptop and waited for link. No link received so 50 mins before appointment time I rang the department. No answer, so left message on answerphone explaining no link received and please could someone phone me back asap.

Got a call back 3 hours later saying we had DNA'd for a face to face appointment! I explained our letter definitely said video consultation and the initially very dubious sounding administrator checked on her computer and saw that this was indeed what we had been sent. She couldn't understand why we had been sent that letter when their department don't even do video consultations . Silly Admin error that wasted everyone's time not just NHS staff - I had to take time off work and DD missed an afternoon of school and then we had to do the same again the following week to attend the re-booked consultation face to face!

Also just wanted to add…. I’m not sure if every Trust uses this, but if you have the NHS app under the “Appointment” tab, there is an option for “Referrals, Hospital and Other Appointments”. All my hospital appointment letters are on there.

I have 3 upcoming appointments for 2023. 2 physical letters have come in the post, the third one hasn’t. But all 3 are on my appointment list electronically which I can reschedule or cancel via the App.

(Obviously I know a lot of the population won’t have smart phones or struggle with technology.)

Sometimes people are unwell on the day, delayed and can’t get through to clinic or there have been admin issues. However, as it’s a surgical procedure usually you’d have a pre assessment so presume it’s not due to admin fail

Hospital admin needs more investment. I bet it was letters messed up.

I had 4 letters for my surgery. 2 arrived on same day one gave date and the other letter said ignore the second letter we sent you with the new date - stick to first date. Then 2 day later another letter came with a different date (is this the 'second' letter I am supposed to ignore I wondered). Phoned hospital (not easy to get through and requires persistence) and they said No!! This was the 'third' letter with the newest and latest date. Glad I phoned else I might have ignored it due to letter telling me to do that.

'Second' letter turned up the following week

I got a letter earlier this year saying that because I hadn't attended an appointment I was being referred back to my GP. I called the clinic and said I wasn't aware that I had an appointment and as far as I was aware, I was still on the waiting list. The snippy receptionist said that text messages were sent to my mobile number to tell me, none of which I had received. She was obviously very doubtful that I hadn't received any communications from them, not even text messages. As soon as she made an appointment for me I got a text message.

I did a temp job in operating theatres and sometimes we would get DNAs, but this was rare. It was much more common that we would have to postpone people who were last on the list to the next day, or cancel a list altogether because of lack of staff.

For two thirds of a list of people not to turn up sounds like a clinic or admin error tbh.

I had a weird pregnancy one. Ghosted by the hospital until I have up, re-booked elsewhere. I’d ring so many times, so many people but they’d never got.
Hospital B was out of area so my post birth hime check was with a midwife from hospital A. She kept arguing I couldn’t have given birth as I was 12 weeks pregnant.
never worked it out

Maybe they're dead? Or didn't receive their letters thanks to Royal Mail strikes and the NHS's reliance on this instead of email/texts for most appointments.

I turned up to my appointment for CBT Monday morning at a hospital sixty miles away years ago. Checked in at the reception, sat, and sat, and sat. Asked what the problem was, told they had cancelled my appointment on the Friday but the mail hadn't been collected...it was sat right next to the receptionist at the top of the inbox.

Although it annoys the hell out of me to think that people who do attend appointments are waiting while staff wait around for people who don't, and everything that wastes, I've also been on the other side and been a DNA a couple of times - the first time was because I received the letter the day of the appointment and the date on the letter was only 2/3 days before that, and I got it when I got home from work at 11pm - rang the next day, and subsequent days because I couldn't get through and was told I was a DNA and should have rang sooner- I don't know how I could attend an appointment I didn't know I had and did ring as soon as I knew.
The second was for an appointment they cancelled and had proof of the cancellation and rearranged appointment - but somehow still got a DNA for not attending.
The NHS is a valuable asset to us and we should be looking after it and not wasting resources, but mine and other experiences also show that much of the waste is coming from within - and everything seems to be so fragmented that it's an almost impossible task to sort that out.

Echo the exasperation felt by patients here. Got a text for my elderly Dad's appointment at Epsom Hospital at 11.30am, the day before his 94th birthday. No explanation as to what it was about. It may have been a colonoscopy as there's been concerns in that area but the the preliminary set phone call with the consultant never happened. That's after we'd been phoned to say the call with the nurse had been cancelled, sort of implying but not saying the tests might be serious.
Got said text on a late Friday I think, couldn't cancel over the weekend, phoned Monday to be told I couldn't cancel because I wasn't down as his Next of Kin! (News to me.) Even though I'm his adult child. Instead they had my sister as Next of Kin and would only take her word for it even though they texted me! I couldn't reach her.
So they had an appointment for God know what, waiting around for a no-show! They'll have me down on the notes as the bad guy.

For security/confidentiality reasons and/or because not all service providers have the systems in place to send automated messages/emails.
I worked in a research post in the NHS in 2016 where we had to use FAX to send patient/participant identifiable information to other parties involved in the study.
Yes, 2016. Fax.