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Missed appointments by patients cost NHS millions
A Southampton GP has revealed the massive impact missed appointments have on his surgery.
Sitting in his GP surgery in Shirley, Dr Daniel Tongue can see with a click of a mouse just how costly Do Not Attends (DNA's) are in both NHS time and money.
Within the last six months Victor Street Surgery, which has around 13,000 registered patients, has seen 3,273 appointments missed by patients - a total of 41,000 wasted minutes.
With the average cost of a ten minute GP appointment estimated at £25, this means that £102,500 was lost by patients not turning up and not bothering to call.
Multiply this by the number of surgeries within the Southampton City Clinical Commissioning Group - 37 - that's an estimated loss of £3.8m in just six months being drained from the cash-strapped NHS.
Dr Tongue, who is also planned care lead for Southampton City Clinical Commissioning Group, said: “It's really frustrating and the nurses certainly find it frustrating.
“Just yesterday one of my nurses who runs a diabetic clinic was telling me how much of an effect DNA's have on the practice.
“On Tuesday only three of her six appointments turned up, leaving her twiddling her thumbs for each of the 30 minute appointments, but yesterday she was running on empty because she had so many extra patients to deal with.
“It does seem to be a growing trend. When I started in the profession eight years ago, the government had introduced the system of booking appointments within 48 hours and back then it didn't seem quite so prevalent.
“But as we move towards booking appointments six weeks in advance, DNA's seem to be rising, despite the whole point of moving back to the advanced system being to make it easier for people to fit in appointments around their daily lives.
“But it is not just a case of those who book in advance forgetting about their appointments. We have some patients who fail to turn up for appointments which they only booked two hours previously, through our emergency booking system.”
As reported by the Daily Echo more than 35,000 patients failed to attend scheduled appointments last year at Southampton General Hospital with 10,000 appointments missed at the Royal Hampshire County Hospital in Winchester.
Two years ago the problem was so bad - more than 60,000 appointments missed in Hampshire at a cost of £6.1m - that the Daily Echo launched its Turn Up or Tell 'Em campaign, to urge patients to ring up and tell hospitals and GP practices f they are unable to make their appointment.
Dr Tongue believes this is a vital message that patients need to take notice of and says that while hospitals will need sufficient notice to fill slots, GP surgeries have the capabilities of being much more flexible with even a ten minute warning enough time to make use of the time.
He added: “People just seem to have other priorities and don't see their doctor's appointments as one of them.
“Even if they called to let us know ten minutes before, there's a chance someone might fill that appointment, because appointments are in such demand.
“People are walking in all the time looking for an appointment, and if we get a call to say a patient cannot make it because they are stuck in traffic, we know we can offer that slot to someone else, instead of waiting around for someone who just isn't going to turn up.”
Solving the problem isn't an easy one and while modern technology is being used in hospitals and GP's practices to make it easier for patients to cancel their appointments, doctors are still left wondering why many still insist on simply not turning up without having the courtesy to call.
“It does seem that because a patient is getting the appointment for free they don't value the service as much”, said Dr Tongue.
“When money is not being exchanged some people forget that it is costing the NHS and the taxpayer is paying for it. They may not be physically paying for it, but someone else is on their behalf and people need to understand that.
“We have to encourage people to value the service we are offering. To have ten per cent of appointments missed is costing the NHS a lot of money.
“I think we do need to understand better the reasons why people simply don't turn up, learn how we can do things to improve it, using technology for example and of course encouraging patients to let us know if they cannot turn up.
“As a practice we have been looking at ways of how we can reduce this problem and help patients to help us. We understand that some people do find it hard to contact their GP surgery so we are doing what we can to improve the system.
“We have the software here to run a text messaging service to remind patients so we are looking to get that up and running smoothly.
“We have also recently introduced online forms and an automated service so that patients don't even need to speak to a person to cancel an appointment. So if someone remembers on a Sunday that they can't make it, they can let the surgery know even when it's closed.
“I am not a believer in imposing financial fines on those who miss appointments. I don't think it would work and it would just create another layer of bureaucracy that would cost just as much.
“I think any form of penalty would be difficult because the ethos of the NHS is based on need and you cannot start turning people away if they need treatment.
“If a surgery notices that a patient regularly misses appointments then they have the power to de-list the patient, forcing them the inconvenience of having to find another practice but that really is the last resort.”