To be really angry with my GP surgery?????

[mosschops30]

Last week I had a double appointment (20 minutes) booked for minor surgery (mole removal) at my GP surger.
I had worked 3 x 12hr shifts prior to this, had not looked in my diary, was completely knackered and missed the appointment.

As soon as I realised I rang the surgery and apologised for any inconvenience and explained the situation.

This morning I received a letter from them which states 'to simply not bother to turn up is unnacceptable and results in a complete waste of valuable doctor time'

I feel a bit pissed off at that given that I did ring and apologise, so do I just let it go over my head and AIBU?

so there you go, you have to have a standard letter, you are just after all a number out of the 2500 letters that week

A standard letter doesn't mean standard treatment. It's a letter - it tells you where to go and what to do - not give you your prognosis! The other side of that is that if patients realise they are one in 2500 it might concentrate their minds as to the finite resources available to serve all those people and thus reduce dnas!

Its a balance really. As patients we can see the waiting and when the admin goes wrong and think that the health service is terribly disorganized. As clinicians/managers in the health service we see patients not really respecting the systems that are supposed to be in place to make this work better. The trouble is that the systems aren't always that patient focused, and they can (and do) break down at times. I don't really think that we should be expecting to be reminded about appointments that we have made ourselves only a week or two before, but do think reminder letters should go out when the appointments are a year in advance and it is very easy to forget. Hospitals have started to be a bit more creative with texts and phone calls, but these require resources for both set up and managing, and that takes time and money away from care, which after all is what the health service is primarily there for. One of the reasons for introducing shared electronic records is to make the communications between different parts of the health service work better (this would stop letters being sent to dead patients for example), but there has been a lot of resistance to this, and the technical side is really lagging still.

With so many people using the health service, or even an individual GP practice of course the routine side of things is not personal. Many letters etc get generated by computers, and DNA letters are no exception because there are too many DNAs to write by hand (and in any case if the death has not been registered on the system then it wouldn't actually make any difference as the person writing the letter wouldn't know any more than the automated programme does). That is not to say that those providing the care do not see people as individuals (although some surgeons I have met do still see the symptom first and the person afterwards...)

I don't think you can rely on Royal Mail to deliver your appointment letter - I hate it when I go to appointments and then they tell me they'll send the follow up appointment in the post - how will I know they've even sent it,let alone it not being lost in the post?

Hence the "need" to let patients know in other ways.

I acknowledge this must take away so many resources, but then so many appointments are missed due to people forgetting them so maybe it's cost efficient after all.

I got sent a text about an appointment I didn't know about, rang up the number on the text to see if it was "correct" and they told me I would have to ring up the clinic myself to confirm. What a waste of time effort and money - if the texting company can't give me the information Iwanted (the specific clinic) then what was the point.

Re me saying I hadn't received an email, I was merely trying to make the point that maybe reminders could come that way too, but that I hadn't received one.

I agree we are adults though and we wouldn't need reminders if we used our diaries, and if we could rely on Royal Mail!

I do my best to run on time. I also do my best to sort out patient's problems in the time allocated without skipping things. If I run late I apologize.

Yesterday I had 6 DNAs. 1 triple appointment, 1 double appointment and a single. And yes, I did sit "twiddling my thumbs". Actually I got on with referrals and paperwork, but that was 6 appointments that we needed yesterday, we were very busy generally.

We give people 20mins after their appointment time. If they are later than that they have to rebook or if they would like to I let them sit and wait until the end of my surgery and I try to fit them in when I can (but not all the docs I work with will do that I am just a bit soft).

This sounds like a standard letter - probably everyone who missed an appointment that day got one.
I'd write and acknowledge the letter, apologise and remind them that you did ring.

Life gets in the way sometimes and we all miss appointments occasionally. The GP surgery I work with has a notice saying that 144 patients did not arrive for appointments last month. Doesn't take a rocket scientist to work out how much time was wasted.

I still don't get it, if you are so busy, and a patient is late, why not get to the next person on the list who is actually there?

If a person is late, but still shows up, it's their tough luck that someone else actually bothered to get there on time..

(I have had more than my fair share of appointments both for myself and DS2, I seem to spend my life sitting in waiting rooms! I did not know that doctors did sit around waiting themselves!)

"If a person is late, but still shows up, it's their tough luck that someone else actually bothered to get there on time.." I agree and if I was ever late as a patient that is how I would see it (if I am late for my dentist, solicitor or optician I am politely sent away and the first two charge me anyway).

The problem is that most people don't see it that way and you get them shouting at the receptionists and then us which makes things run even later. The ones who are usually on time and have something unexpected go wrong are usually very apologetic and I'll squeeze them in when I can but believe me - shouting and being stroppy is more the norm.

If I go as a patient or a parent I aim to be there 20min early so I usually get there a bit later - maybe 5-10 min early. I don't have to mow down pedestrians in my panic to get there or park on double yellow lines so I spend my appointment panicing I will be clamped. I take a book and a drink and a toy for my son and if the doctor is running late I thank my lucky stars that I am in the waiting room and will be home before long and not on the other side of the door trying to catch up and still treat each patient as an individual, give them time to tell their story, examine them properly, explain things clearly and type it up well so the next person can understand what was said.

I agree the post is no longer as reliable as it has been in the past. However I don't think that it is reasonable to expect e-mails, texts, phone calls etc. The vast majority of post is received at the other end, otherwise most businesses would have stopped using the Post Office, and they haven't. When is the last time you didn't get a bill or a statement for example. Anyway, many clinics have started thinking about how to remind people, and looking at different ways to do so. These are meant to supplement normal communications not replace them, which is why the texting service had no info. They are just sending out texts as requested, almost certainly on a contractual basis, and I expect as cheaply and simply as possible (they are also probably not allowed to know anything more about you than your telephone number and the set message because of confidentiality). I can see that this was very annoying when your original letter had been lost, but then it is a reminder service only I am guessing.
Bear in mind that these are additional costs, because although resources are lost every time a patient DNAs there is no way to recoup that money. It's not like a hairdresser (ours now phones) when money is received for each haircut, and the extra cost of ringing can be factored in (and passed on). In the NHS the money just gets moved around - it's all from the taxpayer when it comes down to it.

However I think that as people's lives get busier and technical solutions get cheaper there will be more reliance on electronic communications, and reminders will become more widespread (and probably more automated too).

Regarding whether you are wasting the doctor's time by not turning up, I think it is probably more appropriate to think you are using a resource that could have been used by someone else. The doctor is unlikely to be twiddling their thumbs, but moving admin type work into clinical time reduces the clinical time available to other patients. Surgeries and clinics run much more smoothly if they are predictable, which benefits patients too.

For those GPs on this thread who really want to see their blood pressure rise, read the following:
www.newsoftheworld.co.uk/columnists/carolemalone/48215/Fernrsquos-fat-use-to-op-less-cases.html?post ingId=79512

you will need to scroll down to GIVE GPs A JAB

God she's opinionated isn't she! I doubt very much she knows the small print in the 2004 contract off by heart (why on earth would she - I don't know many doctors who do, or those who have to manage it either for that matter). The rise in pay is quite real, although the 250k doctors are pretty rare, and have this sort of income more because they are managing their businesses than the contract itself. I think many people forget that GP practices are run as small businesses (sometimes quite large businesses). However it is true that the government laid down way too much when the contract was introduced. We were told at the time that we were not allowed to even consider it as a performance management tool, so the idea of rewarding the very good practices and getting the poor ones up to scratch was seriously compromised form the start (which must have really annoyed the best practices). Still don't see why someone whose career is just what precisely (I bet she takes home more than most GPs) feels that other people should work long hours because of vocation not cash - I bet she wouldn't!

What annoyed me was the fact that I had made a date on the phone with the audiologist, then got a letter advising of a different date. I then rang the audiologist back to confirm the different date, and she told me it had been a mistake and not to bother showing up as I had another appointment (the date I had originally made with the audiologist).

Then I got the text confirming the different date, replied to the text, only to be told they couldn't help me! (They advised me I had to ring the dept and confirm / check).

It turned out that it was a different appointment, that the audtologist had told me the wrong thing.

If I had took the audiologist's advise (and why shouldn't I, seeing I had bothered to check) we would have been waiting who knows how long (actually I have some idea - MONTHS), for DS2 to see the consultant about his hearing!

All very confusing.....

I am so sorry, of course, "If I had TAKEN!", posted too quickly!

Oh I'm not saying cock-ups don't happen. Clearly they do, and it is very irritating (and confusing at times too!). Just that the reminder service is almost certainly automated, and the company probably only do processing.

But the same clinic also makes reminder phonecalls, so what is the point of the (uselss) text service?

If I was the GP with whom you had missed a double appointment slot for a minor op you wouldn't have received a letter, you would have received a phonecall from me in person to find out why you hadn't attended and to point out the waste of time you had caused. Usually, it is not just the GPs appointments you have wasted, but those of a clinical assisstant too and the theatre time. I would also refuse to rebook you unless your absence was unavoidable.

I personally very rarely run behind time, as I find it stresses me too much. The occasional DNA allows me some catch-up time for paperwork and checking blood results, but several is frustrating and a waste.

The other problem is that we have very high demand for appointments, and 2x10 minute slots could easily be filled at little notice. These patients still need seeing, and they eventually end up being tagged onto the end of my usual surgery- meaning I leave work 20-30 minutes later than am contracted to. I also have a son who needs picking up from nursery, who gets very upset and tired (and I get charged extra) when I am late collecting him.

oh i know how annoying this is. ds and dd had vcc appt different days, so called and made one day. we had it done. a few days later we had letter " YOUR CHILD IS MISSED...blah blah" called them told them we had it, "OK, dont worry its now int he system" had two more letter for two more appt. called them"OH, dont worry ignore them, we have your record" week later again "YOUR CHILD IS....blah blah"
Guess what i thought "OH bugger off"
Stupid system Just ignore them, and live your life.

These letters must cost so much money!

I got two letters for DS2's hearing tests - same day, same time, two different locations - to save money they combined our PCT's patients with another PCT's patients, so one premises was closed down.

According to the system though it's still operating .

They even told us that because the new premises were so hard to get to (3 buses from where I live) patients were not showing up

Not as much money as missing an appointment.....