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Cost of missed appointments at Norfolk hospitals soars to £10m

09:56 13 October 2014

The cost of "did not attend" outpatient appointments rose to £10m at Norfolk

The cost of "did not attend" outpatient appointments rose to £10m at Norfolk's three acute hospitals last year.

The cost of patients missing appointments at Norfolk’s three main hospitals soared to an estimated £10m last year, according to new figures.

New telephone reminder system

The cost of missed appointments at the West Suffolk Hospital rose from £2m in 2012/13 to £2.2m in 2013/14.

However, officials from the Bury St Edmunds-based trust said the introduction of a telephone reminder system in April had already significantly reduced the number of patients who have not turned up for outpatient appointments.

Between 348 and 773 extra patients each month are attending for appointments since the introduction of the system, which telephones people two weeks in advance to remind them when they are due at the hospital. Patients then receive a further text message reminder two days before their appointment.

The reminders give anyone who cannot attend the chance to let the hospital know by calling or selecting from the options on the automated message, in turn allowing West Suffolk to offer the slot to someone else.

The new initiative has reduced the percentage of did not attends from 5.97pc for the first four months of 2013 to 4.18pc over the same period in 2014.

Debs Wakefield, transformation manager at the hospital, said: “We are really pleased with the impact this new system has had on further reducing the number of missed appointments at West Suffolk Hospital.

“As well as reminding patients who have forgotten their appointment, it’s giving us the opportunity to offer unwanted slots to other people, which helps reduce waiting lists and makes sure everyone receives prompt treatment. We also had some great feedback from patients about the system, with many finding it a really useful tool.

“We can’t treat an empty chair, so urge anyone who cannot come to their appointment to get in touch with us so that we can arrange a suitable alternative.”

Hospital chiefs pledged to look at ways to reduce the number of cancellations and urged people to tell them if they could not make scheduled outpatient appointments.

Figures released under a Freedom of Information request revealed that in 2013/14, there were more than 70,000 did not attend (DNA) cases at the Norfolk and Norwich University Hospital, James Paget University Hospital, in Gorleston, and Queen Elizabeth Hospital, in King’s Lynn.

And with every missed appointment costing the NHS around £150, the estimated cost of patients missing outpatient appointments at the three acute hospitals in Norfolk rose from £9m in 2012/13 to £10m in the last financial year.

The national average of DNAs currently stands at more than 8pc.

At the N&N, almost 6pc of appointments were missed, which cost the hospital £5.7m last year. It comes after bosses from the Colney hospital warned last month that the NHS trust was expecting an £11m budget shortfall next year, as a result of an increase in A&E admissions and attendances.

A spokesman for the hospital added that the percentage of missed appointments had slightly reduced last year, compared with 2012/13.

“There are a several reasons why a patient may not attend a hospital appointment, for example, a patient may feel better and choose not to attend, or a patient may forget their appointment time. In order to reduce the number of DNAs, we send patients SMS text messages to remind them of their appointment time and how to rebook if needed. In some clinics where patients attend regularly, we ask patients to contact us to book an appointment at a time that suits them. Like many healthcare providers, we do also overbook some clinics in anticipation of a small number of DNAs.”

At the JPH, the number of DNA cases reduced slightly from 2012/13 to 2013/14.

Sue Watkinson, interim director or operations at the Gorleston hospital, said a text system for certain patient clinics had been introduced to reduce the number of missed appointments.

“Patients not attending their appointments mean that we could have treated someone else. We do appreciate that sometimes emergency situations arise, so we would request that our patients let us know as soon as possible if they need to cancel.”

“There are many reasons why patients DNA, sometimes it is due to an unforeseen emergency and some of our patients just simply do not keep their appointments. On rare occasions the hospital makes an administrative error and, if so, we apologise and make a suitable alternative at the patient’s convenience,” she said.

The cost of DNAs at the Queen Elizabeth Hospital rose from £1.45m in 2012/13 to £2.38m in the last financial year.

No one was available to comment from the King’s Lynn hospital.

25 comments

  • Why don't you admit you are wrong Bad Form? There is no report by the NHS like you said there was. You made a mistake. You read something quoted in a trashy tabloid and imagined it to be something else. But you now don't want to admit you were mistaken.

    Report this comment

    Cyril the Canary

    Wednesday, October 15, 2014

  • CtC- I answered your question politely and provided you with the name of the publication in which the report was published. The same report is also referred to in an article in one of the national newspapers so invariably can be found if you use the correct search string. While you are busy looking for it online may I suggest you look up what constitutes libel? I'm sure you'll find what you can and can't call a person in print quite illuminating!

    Report this comment

    Bad Form

    Wednesday, October 15, 2014

  • Bad form: I think you misread my question. I asked you what the "NHS research" was that you have referred two twice in your comments on this topic. I can find no evidence of any "NHS" research that says two thirds of people who missed appointments did so deliberately or because of "apathy" Actually let me answer the question for you: The reality is that I can find no reference to any such "NHS research" because clearly it doesn't exist outside of your own delusions.

    Report this comment

    Cyril the Canary

    Tuesday, October 14, 2014

  • A Taylor.. I am not sure if your maths is correct but in my world $500 plus $500 adds up to a $1000 not $600. I would also point out that having used both the U S and Canadian systems, I would have to say that on the whole the U S system is better, in that the Doctors keep the appointment at the appointed time, and you do not have to waste hours waiting for himher to show up. Okay, yes it costs you and your employer more, but when time is of an essence, the U S system is faster. The cost, well I do not know what the NI stamp costs now, but back in the seventies I seem to remember about 35bob or there abouts and that does not include what the taxpayer at large chips in. As most places in the NHS and Canadian systems doubletriple book appointments I would have thought that they would welcome the occaisional missed appointee so as to be able to catch up...

    Report this comment

    canuk

    Tuesday, October 14, 2014

  • CtC - May I suggest you consult an article in The Journal of the Royal Society of Medicine as one source? However, there are plenty of others but they don't always appear on Google!

    Report this comment

    Bad Form

    Tuesday, October 14, 2014

  • I'm under private health insurance when I work in the States. It costs my employer $500 a month and I pay another $500. That's over £600 per month. For that I get the privilege of paying £20 just to see the doctor and £50 if I miss the appointment. I am required to be at the appointment 15 minutes before the appointment time and I usually wait a good half hour or more after that. So I don't have any sympathy when I'm in an NHS waiting room listening to the moaning by people who aren't paying ANYTHING and who are getting, believe me, just as good as healthcare as anyone in the States. Every time I go to James Paget I'm impressed by the quality of the doctors and the nurses. Yes, the facility isn't as pretty as the ones I go to in the states, but that's not a problem to me as long as the doctors and nurses are as good. And they are, every bit of it. At the risk of being a scold, I'll say that everyone in the UK should be grateful for the NHS. It's a blessing. And if I had to pay £5 to make an appointment or a small fine if I didn't show up or bother to call an cancel, I'd still be grateful for the care.

    Report this comment

    ATaylor

    Tuesday, October 14, 2014

  • Well Bad Form what is this mythical NHS "research" that says two thirds of people who miss appointments do so deliberately? I can find no evidence of any such thing.

    Report this comment

    Cyril the Canary

    Monday, October 13, 2014

  • CtC - The research by the NHS is pretty damning. It is the 40% who miss appointments who have genuine reasons for not turning up which leaves 60% (the majority) who haven't. Whilst I readily agree that some hospitals and some departments vary in the quality and efficiency of their administration that misses the point. The point is the onus to attend a free hospital or GP appointment lies with the patient and not the other was around. £10 million pounds wasted is money that comes from everyone who is a taxpayer. It is money that could and should be available to treat patients. I find it as unacceptable to break a hospital appointment as much as I do someone who defrauds the benefits system. In both cases it is taxpayers who are footing the bill and in both cases it's other people who suffer.

    Report this comment

    Bad Form

    Monday, October 13, 2014

  • I'm sure there are plenty of people who deliberately don't attend appointments and don't bother to cancel because they just don't give a damn. But I expect the majority of missed appointments are genuine errors, transport problems or ill confused people getting their dates wrong, losing the letter etc. What we have found is that admin seem to vary hugely between departments both in quality and practice. They all seem to have different appointment management strategies and some will answer the phone immediately and resolve issues, whilst others always seem to be just an answerphone and don't get back to you after you call. The article mentions telephone and text reminder services yet some departments seem to use these and others don't. Perhaps what is needed is a unified appointment system based on best practice with plenty of texttelephone or email reminders being given.

    Report this comment

    Cyril the Canary

    Monday, October 13, 2014

  • As far as I am concerned if you need medical attention, regardless of GP or hospital, you should be willing to wait however long for your turn in the surgery or clinic session you have been allotted. Yes it can be boring, and inconvenient, but we are darn lucky to have the publicly funded service. I have had experience of both private and nhs surgery and while the private service is more convenient and accomodation more comfortable it costs thousands of pounds. An MRI scan 5 yrs ago was £650.00 at the Sandringham, the wifes gyne op was just under £8000, her carpel tunnel just under £2000 so what if you have to sit and wait for an hour or two to get your test, proceedure etc done for free.

    Report this comment

    Canary Boy

    Monday, October 13, 2014

  • Andy T - I've been to both private and NHS hospitals and I can assure you waiting to see someone isn't exclusive just to the NHS! Whilst an ageing population is to some extent a reason for some of the problems the NHS faces a far greater one is people abusing the system. People who needlessly go to their GP for trivial reasons. People who call ambulances because they can't be bothered to learn basic first aid and stub their toe, people who get drunk etc. Oh and I forgot, the ones who believe that everything stops just for them! If you'd lived abroad you'd know that where people have to pay a fee to see their GP the system works far better than it does here. The NHS can't afford to have people abusing it like is happening now. Bringing in sensible charges to see your GP would benefit everyone and especially those who need to see their GP due to chronic or serious illness. Of course, the alternative is to be happy that you've an unnecessarily long wait to see a consultant. To be comfortable with people deciding that they forgot they'd got an appointment at the hairdresser so couldn't be bothered to make the hospital appointment etc etc.

    Report this comment

    Bad Form

    Monday, October 13, 2014

  • Frank, the research by the NHS showed that 60%, yes 60%, had no reason to miss their appointments. That will exclude people who didn't turn up for medical or social reasons. Stop trying to invent excuses for people who abuse the system. If you abuse it you should lose it....simple!

    Report this comment

    Bad Form

    Monday, October 13, 2014

  • Not much mention of the people that turn up on time and have to wait. Their time is also worth money but is sadly disregarded...

    Report this comment

    Andy T

    Monday, October 13, 2014

  • Simple answer is to invoice people for missed appointments. the system does need looking at though. Chatting with people waiting with em for an appointment at JPH, we found that 6 of us had the same time to see the same person. When we asked why this was, we were told that appointment times are for a session, not a specific time! Hence the wait of over an hour when turning up in time.

    Report this comment

    DaveG

    Monday, October 13, 2014

  • If people don’t ascribe a value to the hospitals time, of course a minority will abuse the system and chose not to attend appointments reserved for them. If everyone was charged even a small sum, say £50 for each appointment (with a small reduction in taxation to compensate) then I would suggest that the problem would be vastly reduced.

    Report this comment

    Voice of Reason

    Monday, October 13, 2014

  • People who do not turn up for either GP or hospital appointment should be charged simple as that. The only discretion should be for those with dementia. Mind my father rang to cancel his appointment for Thursday this morning and could only get a recorded message saying that due to technical difficulties the phone system was not operating. He left his name and number, as requested, so hopefully someone will contact him when they are back to full staffing levels. Alternately he will try again tomorrow so someone can be allocated his appointment.

    Report this comment

    Canary Boy

    Monday, October 13, 2014

  • Some of those missing appointments will be folk who suffer from confusion as part of their conditions. This should be borne in mind before rushing to demand people pay for appointments missed. It may be that this story & trend is a stealthy attempt to undermine our free at point of use health service by those who want to make money out of our suffering & exclude those who cannot pay.

    Report this comment

    Frank

    Monday, October 13, 2014

  • NHS research suggests that over 60% of broken appointments are down to apathy. Apathy is this case means that someone has to wait longer to get an appointment in the first place. In effect those people and their apathy are abusing other patients and, of course, taxpayers. The NHS is free but being free has led to complacency and abuse. It really is time people got their priorities right. Having a free NHS should be seen as a privilege and not a God given right. It really is time that people were made to pay to see a GP and to have a hospital appointment. I wonder then how many people would be prepared to see their money wasted because they were too apathetic to attend an appointment they'd paid for? Not many, I bet!

    Report this comment

    Bad Form

    Monday, October 13, 2014

  • Just to clarify my earlier post. The consultant said my husband should not be at cromer until he had received an appointment at Norwich. he was therefore not seen at Cromer. It cost my husband (self employed) a whole afternoon off work ..... I am sure NHS workers wouldn't be happy if they weren't paid for a missed afternoon.

    Report this comment

    samphirelover

    Monday, October 13, 2014

  • It could be something to do with their terrible system of sending out incorrect appointments. My husband recently took an afternoon off work to attend an appointment at Cromer hospital as per his letter and was told by the consultant it was incorrect and he apologised on behalf of the NHS. Likewise, I received 3 letters for appointments at the N and N for 1 appointment, all with different times. That took some sorting out!

    Report this comment

    samphirelover

    Monday, October 13, 2014

  • In the context of outpatients clinics and treatment clinics (but not elective surgery )I have yet to attend and be seen at the time of my appointment-even when the time was one of the first in the morning. These figures seem plucked from the air to me since it feels as if the system is at full stretch anyway. However anything that makes it more efficient has to be welcome and one wonders if better transport to and from outpatients clinics for non drivers in remote areas would help-even if they contributed to the cost.

    Report this comment

    Daisy Roots

    Monday, October 13, 2014

  • The answer here is simple and to charge people for missed appointments, both at hospitals and at GP’s surgeries. If these people had to pay a £150 each time they missed an appointment, perhaps they would be a little more diligent.

    Report this comment

    Norfolk John

    Monday, October 13, 2014

  • I have arrived at Norwich for a 4.430 appointment at 3.45 sat and waited until 5.15 until I asked when I would be seen as people were arriving at 4.45 and going in only to be told they had had rang and said they had been held up it still didn't make sense to me I think their booking system needs looking at

    Report this comment

    i am mostly wrong??

    Monday, October 13, 2014

  • EVERYONE I know who has attended an appointment at Norwich has had to wait well beyond their appointment time to see someone. That is EVERYONE, not most people I know, not even almost everyone I know, BUT EVERYONE. So all these missed appointments must be helping things, not costing them money. If the hospital constantly run late, which is clearly does. Then there is no way that any missed appointment can do anything but help them from running even later. I think the hospital needs to be far more honest about missed appointments. What percentage of them, leave the staff with no one to see during that period? & what percentage of those who fail to turn up, help the hospital not run even later, than they already are?. As someone said Lies, dammed lies & then statistics.

    Report this comment

    el84

    Monday, October 13, 2014

  • I know of several people who have missed appointments at the University hospital because they couldn't find anywhere to park, I wonder how common this is ?

    Report this comment

    D. ROSS

    Monday, October 13, 2014

The views expressed in the above comments do not necessarily reflect the views of this site

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