Hospital no-shows

JohnC6

JohnC6

Messages
10,447
Name
John
Edit My Images
Yes
Following x-rays re my shoulder injury at the A&E recently, I was given an appointment in the week at the Cheltenham Orthopaedics/fracture unit where I saw a consultant. No fracture.. BUT... in the waiting area there was a notice on the wall regarding patients who failed to keep appointments. In the previous week it was 59. For April it was 169. It beggars belief. That's about 40 missed appointments per week. I recall there was a suggestion last year, by some ministers, that a charge of £10 should be made for missed appointments at surgeries and hospitals. It was criticised by the chairman of the BMA. The suggestion was shelved. There are two aspects .The precious time of the consultants/doctors/nursing staff is wasted and patients who would keep appointments have had to wait longer.
 
I agree with the charge - but how could it be collected? This is where systems like the French are good, you have to pay but can claim it back, for seeing a doctor etc
 
The problem with such 'solutions' is that they very often fail to consider why people don't show up. I missed an appointment last week because I had an absolute nightmare with buses; was something like a 40 minute delay, and that's in London where you seldom have to wait longer than 5 mins. I had no option with minicabs, as I was in an LTN which cabs refuse to enter, and I couldn't make my way on foot as I'm temporarily hindered in that regard. So I had no choice but to wait. I was lucky enough to get an appointment within half an hour of actually getting there, but my missed appt will be marked down as such. Not my fault, I made every reasonable effort to get there, events just worked against me. I tried to 'phone through but the system wasn't working, just went to a voicemail that then didn't even work, and disconnected.

Another aspect is that appointments are often made without consulting the patient; I've had appointments made for me that I couldn't attend (had they consulted me first, then this would have been avoided), so an alternative has to be arranged. Often, the initial appointment won't be deleted/amended on the system. Inefficiencies caused by underinvestment etc.

Of course, sometimes people just can't be bothered/forget. Sometimes, the arrangement system is such a pain that people can't be bothered to go through it all(I know I've been guilty of this). Not defending it, just telling it how it is really. People are human. I've turned up to appointments only to discover the medical professional hasn't, and I've not been informed. That can cost the patient time and money, and be massively inconvenient. If you're going to 'fine' people for non attendance (without adequate/prior explanation), then patients have to be compensated equally. I've suffered more failed appointments because of this than through my own fault. I've also attended only to discover I've been told to go to the wrong place (not good if you're several miles away from the right place). Lots of failures on the admin side.

So the trouble with using such stats to 'shame' people is disingenuous because it fails to recognise why appointments are actually missed. And quite a number of medical people I know secretly quite like missed appointments; it allows them sufficient time with attending patients (most consultation times are woefully inadequate so apps routinely overrun), allows them to catch up with inevitable backlogs, or do other stuff they generally don't have time to do.

Let's stop blaming patients, without sufficient explanation or context, and let's instead put the blame where it really lies. And we all know where that is.
 
I agree that no-shows are totally unacceptable. However, I do wonder if the hospitals are not exactly helping themselves (in certain cases).

I have an outpatients appoiintment on Tuesday. Yesterday I had a text (!) saying "Please refer to your appointment letter which informs you whether you need to attend the hospital, or be available for your consultation by telephone...."

All well and good, but WHAT appointment letter. The post for today has been and gone, Monday is a Bank Holiday, and I shall have to leave for the Hospital before Tuesday's post. No letter!

Of course, I shall attend, but I could understand someone (e.g. having to organise taxis, etc.) not doing so. There is a complete lack of joined up thinking at the moment, I feel.
 
Given my appointment next Thursday has been re-arranged twice since it was made two weeks ago, I'm going to say that people missing appointments is entirely understandable. Never mind that there is now no bus from where I live to anywhere even vaguely close to the hospital (OK that's the fault of the council and not the NHS).

I've had three letters in the post about that appointment, each with a different date, so three lots of printing and envelopes and three postage charges when they could have sent email. The NHS short of of money? Don't make me laugh, not if they insist on printing and posting letters and won't even offer the option to receive communication by email. One of my friends is a GP and I was recounting this to her and she was horrified at the wanton wasting of money by the hospital.
 
lindsay said:
Good points @Abdichoudxyz @Whitefiver well made. It's not as simple as it seems.
Click to expand...
Also, if you read Freakonomics, the evidence seems to suggest that charging people for not turning up actually increases no shows.

If it's simply "the wrong thing to do" then many people don't do it. If there's a cost involved many people feel justified in paying it and not turning up.
 
onomatopoeia said:
One of my friends is a GP and I was recounting this to her and she was horrified at the wanton wasting of money by the hospital.
Click to expand...
Working in healthcare, GPs generally are not in any sound place to be able to comment on others wantonly wasting money.
 
You must log in or register to reply here.
Back
Top