GP Appt no shows

[jmn]

I had a telephone consultation with my GP yesterday.

I live in a seaside town in Devon, population around 80000.

During the discussion she stated that approximately 30% of the GP appts for that practice were no shows or no answer to the phone.

Is this typical throughout the UK? If so is there a reasonable case for levying a charge for non attendance without prior notice or reasonable excuse?

[randlemarcus]

I think that in-person no shows ought to be chargeable, or "miss two, get deregistered". Phone calls, I rather suspect the callerID is blocked, and who answers an unknown number?

[Actual]

My uncle is blind and almost deaf with Parkinsons and is housebound living alone. He basically sits in chair all day. The front door is unlocked and meals on wheels and anyone who knows just walks straight in. If there is knock at the door he won't hear it and by the time he gets to the door they are gone. If the telephone rings he cant answer in time and when he does he fumbles the phone and gets cut off so callers must call again in a few minutes until they get though. How does he manage but he does and actually he is now recently in a care home but this is how it was.

He gets nurse and doctor calls and visits and even hospital appointments but he can't hear the phone or read the letters and so unless they know his circumstances he misses the appointment. It doesn't matter much to him because they can't do much to help anyway.

This could be one reason for missed appointments.

[Riley Blue]

Here are the DNA (Did Not Attend) figures for three of the smaller surgeries at the practice I go to, there are nine surgeries in total in the practice.

[Tom8]

Would be far more effective having a deposit system for GP and A&E. So many wasted and so many un needed appointments which contribute to wait times and waste.

[boyse7en]

Riley Blue said:

Here are the DNA (Did Not Attend) figures for three of the smaller surgeries at the practice I go to, there are nine surgeries in total in the practice.

Which is just under 6%. No ideal, but with a combination of forgot, didn't know, bad traffic, change of circumstance etc I'd expect that to be about right.

I agree in principle to charging for missed appointments, but the practicalities don't add up. Who would administer it, and pay for the staff to do so? Just that one surgery needs 332 letters sent out, chased up, payments taken, arguments made etc. To make it even cost neutral you would have to "fine" people £50-£100 each, which would be a heavy burden on those least able to pay.

[4Q]

Whilst I'm not condoning missed appointments in any way I'd just to add another side to this.
I made an appointment at my doctors for an issue I had with wrist pain, which as it wasn't urgent the first appointment I could get was three weeks away. A few days before my appointment I called my doctors to cancel and was on hold in their queuing system for nearly an hour! I was number 8 in line when I started and stayed at number 2 for 25 mins (maybe the receptionist went on a break?).
Most people would've given up long before that which would register as a missed appointment. The doctors really don't help themselves by only having appointments weeks in advance and then making a pain in the arse to cancel.

[V8covin]

I've had 2 telephone appointments with a hospital consultant,on both occasions HE failed to make the appointment

[Actual]

The missed appointments statistics could be just a cynical management smokescreen to deflect from the general poor service provided by a practice which is overworked and under resourced so not reflection on the individuals involved.

I expect that once genuine reasons for missing appointments are taken into account the numbers are rather small and do we believe that these doctors and nurses really sit round doing nothing or do they catch up with their backlog or give another deserving patient more time?

My dad died so he could have missed a few appointments but should he be fined?

[r3g]

boyse7en said:

Riley Blue said:

Here are the DNA (Did Not Attend) figures for three of the smaller surgeries at the practice I go to, there are nine surgeries in total in the practice.

Which is just under 6%. No ideal, but with a combination of forgot, didn't know, bad traffic, change of circumstance etc I'd expect that to be about right.

I agree in principle to charging for missed appointments, but the practicalities don't add up. Who would administer it, and pay for the staff to do so? Just that one surgery needs 332 letters sent out, chased up, payments taken, arguments made etc. To make it even cost neutral you would have to "fine" people £50-£100 each, which would be a heavy burden on those least able to pay.

"Who would administer it?". NHS Dentist places seem to manage just fine so I don't see any reason why a GP place can't. At my place you get a major bking and letter if you miss an appointment and if you do it a 2nd time there's a charge of £65 to be paid before you can book another appointment (presumably roughly equivalent to the cost of a tier 2 appointment for the lost time) and if you don't pay that you get struck off. Perfectly reasonable imo. Hit the lazy and feckless in their pockets. The vast majority of their health issues are a direct consequence of their own poor life choices anyway.

[bigpriest]

r3g said:

boyse7en said:

Riley Blue said:

Here are the DNA (Did Not Attend) figures for three of the smaller surgeries at the practice I go to, there are nine surgeries in total in the practice.

Which is just under 6%. No ideal, but with a combination of forgot, didn't know, bad traffic, change of circumstance etc I'd expect that to be about right.

I agree in principle to charging for missed appointments, but the practicalities don't add up. Who would administer it, and pay for the staff to do so? Just that one surgery needs 332 letters sent out, chased up, payments taken, arguments made etc. To make it even cost neutral you would have to "fine" people £50-£100 each, which would be a heavy burden on those least able to pay.

"Who would administer it?". NHS Dentist places seem to manage just fine so I don't see any reason why a GP place can't. At my place you get a major bking and letter if you miss an appointment and if you do it a 2nd time there's a charge of £65 to be paid before you can book another appointment (presumably roughly equivalent to the cost of a tier 2 appointment for the lost time) and if you don't pay that you get struck off. Perfectly reasonable imo. Hit the lazy and feckless in their pockets. The vast majority of their health issues are a direct consequence of their own poor life choices anyway.

Patients who were kicked off the list would then have to register at another practice - but probably wouldn't be able to so would contact NHS England and be 'assigned' a GP practice. This is rota based so the original practice may end up with the same patient.

[r3g]

bigpriest said:

Patients who were kicked off the list would then have to register at another practice - but probably wouldn't be able to so would contact NHS England and be 'assigned' a GP practice. This is rota based so the original practice may end up with the same patient.

The system would need a bit of rework to prevent from happening. Maybe a system like the dental teaching hospitals? Round here there is a shortage of NHS dentists with none available to be '(re)assigned' to, so if you need urgent attention you have to get yourself down to the dental hospital in Leeds where you are used for practice by the kids doing their dental degree. I'm sure it wouldn't be hard to create an equivalent system for the feckless to be seen by a kid doing his/her GP doctor degree.

[MitchT]

Yes, levy a charge against no-shows or people who turn up late and use the money to compensate those of us who turn up on time, only to find that our appointment is running late.

[r3g]

MitchT said:

Yes, levy a charge against no-shows or people who turn up late and use the money to compensate those of us who turn up on time, only to find that our appointment is running late.

That's a whole discussion of its own, Mitch! My last 2 (NHS) dental appointments were 50 mins late and 30 mins late, respectively . I did consider piping up to air my thoughts on the matter with the receptionists but common sense prevailed and I kept my gob shut for once in my life .