To think that if you cancel on the day with the NHS, you should be put to the bottom of the list?

[SaltAirAndTheRust]

Unless you have a good reason of course!

I’ve just started and I’m in my first week, in this week we’ve had multiple cancel due to nerves or just not turning up. Seeing the amount of work that gets them to this point, it’s staggering! I just can’t get my head around it

On 3 occasions I received the letter the day before or the day of the appointment- leaving absolutely no opportunity to attend!

Where I live you need to book a taxi a week or more in advance. There’s no uber in rural areas!

Do the 50% that need chasing actually attend when given a time and day via letter?

(In case that comes across as challenging, I'm genuinely asking)

I'd say it depends on the person.
I have a friend with many complex health issues, both physical and mental. Whilst they do often get appointments scheduled that they can attend, sometimes they get rescheduled and their organised transport falls through, or the support that was supposed to be provided isn't available, in which case the friend has to cancel (and sometimes on the day). They've also had to cancel on the day owing to being unexpectedly quite unwell.

'Do the 50% that need chasing actually attend when given a time and day via letter?'

It used to vary, but not usually, no! We would try to get hold of them 3 times either via SMS or email, then send the letter with a booked appointment as a last resort. I was doing all this admin myself as a band 7 clinician, because the actual admin support we had was so limited. You're constantly trying to do far too much with far too little

I don't think you're the right fit for a "caring" profession if you don't understand nerves/anxiety!

@Taztoy

and I’ve tried ringing the number on the letter but it rings out.

Yup, OH has just gone through the same. He has an appt letter from our local ENT for a severe throat lump which may be linked to his cancer. Two phone numbers at the top of the letter - one just rings and rings - he's tried numerous times over the past couple of weeks, the other number is unobtainable. He phoned ENT reception and they said they couldn't help and he needed to speak to the appointments dept and just gave him the same numbers he already had that didn't work!

If the NHS can't even get the right phone numbers on their letters, they really can't be surprised if patients miss appointments.

This. ^

You sound unkind and unfeeling @SaltAirAndTheRust How on earth did you make it through the interview and secure this job? You must have really faked it!

I understand nerves. I’ve been on the other side of it - but cancelling on the day just means everyone is affected.

I seem to remember more or less - the stats program on radio 4 looking into the x money lost though missed appointment claims - and found while frustrating it was nonsense about money lost.

Turns out the staff aren't daft and don't sit there twiddling their thumb at worse the pop to toilet get a drink and most get on with paper work or see next patient - and many services expect a certain number of no shows anyway.

I think the issue is that cuts within NHS have often been focused on back room admin staff as that's poltically acceptable - but it ends up with poor communication that wastes time and resources anyway but it's more hidden issue.

Yep. Been here a week and can confirm - there’s not enough staff.

While I admire your initiative and obvious good intentions, as a retired NHS manager I think I'd say you were not using your time as a band 7 clinician very well.

Because appointment letters "drove you round the bend" you were personally emailing and texting outpatient appointments yourself and then chasing up the 50% who didn't reply? Was that a good use of your time?

You were basically only covering up the fact that your admin support was ineffective or non-existent and perhaps preventing anyone from looking at the problem.

"We don't need to give them any more A&C support, Lottapianos seems happy to do it"

And I always prefer to get notification by letter, not text or email

The admin work that gets to an appointment though is massive - and especially for things like operations. Where you can’t just do something else during that slot - at best you can move the next patient up the list, but you’re still stuck with a theatre slot that’s booked and prepped but unused

It’s certainly not what they should be doing. You also do get text messages, they appear on your NHS app and you can and often do get phone calls. I just find it a bit disingenuous to act like you’re never told about appointments

There are a lot of 'shoulds' in your comments, OP. People should do this, they should do that, the NHS should be doing this, etc. Well life isn't that simple. The fact is, life is complex, as much as many like to pretend it isn't, and if you're going to work in healthcare you're going to be seeing the real thick of complex human lives. If you can't contain your indignance at this early stage, you're going to struggle.

The fact is, the NHS is under-funded. That's the problem. Human beings seeking healthcare are never, ever going to be perfect, they will very often be annoying, inconsistent, inconvenient. That's the nature of giving help to people. Funding, however, is an issue that COULD be sorted out, if we ever had a government who preferred funding healthcare over wars and corporate tax breaks.

(edit: spelling)

Nobody has claimed they're never told about appointments, like you didn't claim that no patient ever turns up for appointments.

I cancelled an appointment with a few weeks notice, to attend my dad’s funeral (hopefully an acceptable reason to the OP). I’d already waited a year for the appointment but the replacement date was 9 months later. So I think this already happens.

I don't think you can just dismiss people who say that they were never notified of an appointment as being disingenuous. It obviously happens.

What I will say is that it's never happened to me and I always ask for notification of appointments by letter.

I'll also add for the record that my GP practice provides a wonderful service (never have a problem getting an appointment) and having had several referrals to my local hospital over the last couple of years I can say that they also provide a great service and there are no complaints from me.

(I often read letters in the local press moaning about our hospital but my experience has always been good)

You are in your FIRST week and are already spouting what patients should and shouldn’t do?

Also, is today your day off, or are you on some kind of extended lunch break?

It’s not an issue for me. I live and die by my phone calendar. So when I get told about an appointment by the consultant (next review this date etc) it goes in then, and I will then know to book A/L or whatever. That’s fine, I’m tech competent and have no issue navigating this. I had an appointment letter for my daughter’s broken arm consultation 2 weeks ago to get her cast removed. Her cast was removed about 2 months before that. Obviously I didn’t miss the appointment, as her cast was already off at this point.

that said, there are some people who find apps baffling and smart phones overwhelming or confusing. They rely on their letters. The NHS is really, really shit at advising of appointments. It’s not hard. Print a letter and put it in an envelope and frank it and off it goes. I know how easy it is because 15 years ago it was my job. But that doesn’t mean loads of parts of the NHS aren’t totally shit.

I posted on my lunch and then disappeared until my day ended? Is that okay with you?

Also @SaltAirAndTheRust, while it may not be what they should be doing, it is what they ARE doing. And shoulda woulda coulda- doesn’t matter. You’re talking about deprioritising someone’s clinical treatment based on non-attendance, which, for all you know, is your own departments fault.

I thought it before I started. But before then I’d not seen the sheer work that goes into getting patients through the door. Extra clinics. Weekend and evening appointments. Hours of admin work. Just for them to not turn up on the day.

I don’t think you can pass judgement after 3.5 days.