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.

Until we get a backbone and fine people for not turning up this will keep happening. People act to the limit of their consequences. The trouble is that they worry about some people not being able to afford the fine, but I have never come across a parking officer who says "don't worry, Love". If parking companies can fine people £50 or more then so can the NHS. I genuinely think a relatively small sum like that (comparative to the cost of the NHS appointment) would make a big difference.

A two year wait for heart surgery? It’s quite possible the others have passed on in that time.

HAH! You are entirely right, and those who did that should be sent to the USA for future medical treatment. Let them learn how very lucky they are!

We tend to use the NHS more as age-related diseases kick in. Expecting every 80-year-old to scan a QR code with their smartphone is doomed to failure.

Humans to communicate with would help a lot as would linkages between public transport and appointment times - I could have driven myself to my recent minor-op, but wouldn't have been able to drive myself home.

Systems like letters arriving in a standard format in large print, telephone numbers quoted relating to the ward or unit rather than the main switchboard, numerical codes to use on the telephone or by text to cancel/reschedule appointments. Those kinds of things cost pennies and could boost attendance by patients keen to be there.

Agreed.

But there also needs to be a system in place to be able to cancel/reschedule appointments easily.

When I fell pregnant, I couldn't make my scan appointment that was sent through the post. When I called to change my appointment, I kept getting put through to an admin's number that nobody picked up. It just rang endlessly until the line eventually cut off. I tried about 5 times.

We get patients who the bookings team literally call the day before their appointment and they confirm they are coming and then don't show up on the day. It's bizarre tbh.

On the flip side, I travelled for an hour this morning to a hospital appointment. I got the letter for the appointment 4 weeks ago, had the blood tests needed last week, got a text on Friday reminding me about the appointment.
I got there to be told that they'd made a mistake and my appointment was in January and that theyd been trying to ring me for a week to let me know. They hadnt rung me at all. They only have my mobile number, i double checked the number with them and I've had no missed calls and no messages apart from the one on Friday to confirm the appointment

OP if you work on the basis that most humans are a bit thick, the world starts to make a lot more sense. Obviously no intelligent person would miss an important heart operation.

I’d put good money on the odds that the DNAs are ones who’ve likely never paid a penny into the system, or very little. Many don’t value what they don’t pay for and their freeloading ways go hand in hand with an attitude of entitlement. Since they missed some serious surgery, maybe they won’t be a burden for too much longer… (I kid, I kid…)

My mums eye care is under a team at a major regional hospital but she attends a clinic at her local hospital. The letters she gets has the major regional hospital details all over it, you have to read it very carefully to understand that she needs to go to the local place for her appointment. It’s a densely written A4 sheet in standard sized text. Aimed at elderly patients with vision problems. It’s forehead slapping daftness. She needs one cover sheet in large text saying “Dear Mrs Funnelsmum, your next eye appointment is at Local Hospital on Date at Time. If you can’t make it please ring Number We Will Answer in Clinic Hours.” That’s it. They can send all sorts of other bumpf if they have to, but it won’t get read.

in the old days I remember getting postcards from the dentist with reminders on but I suppose patient confidentiality meant that’s not an option these days (even if post could be relied on)

In recent years I have had texts to remind me of gp and eye hospital appointments.

DD is a pediatric OT and in the summer only 2 out 5 parents turned up for their child's appointments

And mine…

I did know someone who did DNA for an vital heart op. He was convinced he would die if he had it done... his anxiety ate him up.
He was not thick either, like you are implying.

Obviously you are joking, but it’s going to form part of my anecdotal experience of reasons why some of these things might happen.
I won’t bore with why, but as a whole, and for various reasons, my wider family are what I would call ‘heavy’ users of the NHS. And I have/have had to advocate for more than one of them. A few scenarios that have happened to us:
1 Three separate appointments all booked for our local hub surgery (half hour appointments for three people for asthma reviews). Booked via their online service, confirmed via their own text message system. All had to be cancelled as our holiday flights home were cancelled and we wouldn’t have got home in time. Followed their instructions for cancelling via the text message system well within the timeframe. Received text confirmation of cancellation. Got call from surgery asking why we didn’t show up - was able to show them the text msg cancellation and conf. No answer to what had gone wrong but the Dr sat for and hour and half that day not seeing other patients cos we weren’t there.
2 Husband had a brain tumour a few years back. Lots of varied appointments at various locations with various people. One booked at KCH London, a loooong way from where we live, cancelled last minute (after we’d arranged transport and hotel at cost to us) and we received a letter in post saying it was moved to our local hospital at 8am the following Sunday morning. Excellent we thought, better for us. Until we arrive to a department in darkness and are told by the main reception desk, that department is never, and has never been, open Sundays.
3 also re brain tumour - appointment with endocrinologist booked, and subsequently cancelled three times within an 18 month period. All by letters in post. Then a letter informing us DH missed his appointment. We were able to show them the letter we received cancelling said appointment.
4 and now to my original point. My DF, in hospital unfortunately since just before Covid shut everything down. I had to do all his care and advocating by phone and couldn’t get to see either him or the people caring for him. In a hospital in Essex, with various procedures booked. Suddenly get letters for him referring to a procedure booked for him at Homerton Hospital London - not the same care authority. No one could work out why it was booked for there, and in any case he’d already been seen at original hospital. Twice I cancelled the appointment, and yet they kept rebooking it whilst totally unable to explain why. By the time the last letter came through with the third appointment, my father had already passed away.
The whole system is fucked.

@NoDramaMama12 I completely agree. There is no excuse for that. The NHS costs the taxpayer half a billion pounds a day. It really is not beyond the wit of a local hospital to be able to make sure that this is possible. I had the same years ago. I left messages all over the place, but then received a nasty letter saying I hadn't attended my appointment. Recently my Dad sat by the phone all afternoon waiting for a consultant to ring for a telephone appointment. The call never came. Apparently there is a six month waiting list for the next one. This is for an operation that he needs and that it was first suggested he need back in the winter of 2019/2020 (three years ago). They lost the scan, causing a huge delay. You really couldn't make it up. All the while he is in pain and his quality of life is rapidly diminishing.

Nah sorry, anyone with any empathy or forward thinking would make the call at least the day before whether they thought they could go through with the OP. Just pulling a no show is stupid.

If a certain proportion of appointments are no shows, the NHS should be planning accordingly (ie overbooking) when it makes procedures and other appointments so that staff time isn’t wasted. Yes, it will mean that occasionally some people won’t be seen as planned because everyone has showed up and so offices and hospitals are overbooked. However, it just seems like bad management for a surgical team to stand around waiting for people to show up for appointments if it’s entirely predictable that some people will be DNAs and there’s a two year wait time.

Yanbu
However i had a pre assessment for surgery and told the wait is up to a year and not to call i would get a letter. I gave it till 12m was up and called as was due to see a specialist in that area.
They said id been removed off list as i hadn't turned up 8 months prior!
I had no letter whatsoever. I said normally appointments arw text too. She said not for surgery
So had to go back to specialist to be referred again

My DP had a fracture clinic appointment a while back. He received about 6 texts a day for the 2 days before and day of the appointment reminding him about it 😂 It was ok at first but ended up being quite annoying. Reading this thread I now understand it!!

That hospital trust has clearly gone to an extreme with the reminders but evidently for good reason. I wonder what their DNA rate would be without them.

Really?
Are you someone who has had to actually face this?

In the European system I'm in, missed appointments are paid for. Some leniency is offered for emergencies (if you call to explain). Appointments have to be cancelled 24 hours in advance.

In 20 years I have never paid for a missed appointment, because I have either been there or cancelled in time.(I did once accidentally turn up the day before).

BUT, patients get a say about when their appointments will take place. They don't go home and wait for a possible letter or phone call for an appointment in two years' time!

I am pretty certain that if the NHS adopted both approaches (charging for missed appointments and giving the patients options regarding date/time,) their efficiency would increase overnight and the DNA rate would fall significantly.

It's free for them, so they don't care.

I love the NHS but think there needs to be something that means people feel the consequences of no shows - Im not sure what and likely the admin would be cost prohibitive but there really should be a way to charge people if they don't cancel with enough notice.

I waited 2.5 years for an appointment and then missed it because we took our first holiday in four years. Two weeks later we came home to a letter about an appointment that had already passed. I tried calling them several times before we left but it kept ringing and no one ever picked up.

I think the assumption that adding another layer of admin into the processes would somehow make it easier and less appointments would be missed is really naive.

How many appointments are genuinely missed because someone thinks “I can’t be arsed today?”

And how would you safeguard the people who didn’t get letters, got letters late, couldn’t get through to cancel or rearrange, take ill on the day, have disabilities or mental health issues that stop them getting to the hospital, have technology difficulty so can’t cancel/get through to rearrange, or who simply make a mistake about the date of the appointment that was originally made 2 years ago and has subsequently been changed half a dozen times?

Plus what then happens when someone gets fined? What’s the financial implication of banning Steve from having another MRI appointment until he pays up, but then he ends up with a much more difficult, and expensive, condition to treat by the time he ends up in A&E weeks and months later?

And what happens to Betty who missed hers because of her learning difficulties and is on benefits so she can’t afford the fine? Does she just get left until her condition is critical or do people with difficulties end up not being fined which then adds another layer of admin because they then have to work out who should and shouldn’t be fined depending on their circumstances?
and how is that done in a timely fashion so that Mary, who never got a letter, doesn’t end up with her cancer professing further while she waits on a decision about something that wasn’t her fault?

Theres a reason it’s never been implemented on any of the occasions it’s been mooted. Because it’s just not a good idea.

and actually only benefits the NT people who actively chose not to bother and can afford the fine because their new appointment will be much sooner if all the people with issues get bumped out of the way!

Personally, I had a letter today for an appointment for 8th December. Not helpful.

My friend kept getting appointments for pregnancy scans after a traumatic miscarriage despite them being informed.

The system is a mess and definitely needs looking at.