Monday, 1 October 2012

Oh, We Value Our ‘World Class NHS’ So Much…

…we’re so grateful it’s ‘free at the point of access’, aren’t we?
The dial-a-cure system starts next week after almost 45,000 patients missed their appointments at the University Hospital of North Staffordshire in 12 months.
Managers say that accounts for just under 10 per cent of all outpatient appointments, wastes hundreds of thousands of pounds a year and makes waiting lists longer.
The cost for this automated system isn’t given. So I suspect it’s high.
The new system will see patients receive an automated call a week before their appointment.
A text message is then sent nearer the time.
If you need that sort of reminder system, then perhaps you should be getting an extra appointment in the neurological ward?
NHS watchdogs and patients today welcomed the crackdown on hospital no-shows.
What ‘crackdown’?

A ‘crackdown’ would be if they put in a ‘three missed appointments and you won’t get another’ policy. This isn’t a crackdown, and everybody, from the service users quoted in the article to the people running the hospital service, is bending over backwards to try to be non-judgemental about the people that don’t keep the appointments:
George Hughes, aged 68, of Weston Coyney, who has had several heart attacks, said: "This is a belting idea.
"The new hospital is superb but I think one reason people don't turn up is the fear factor – they'd rather not know how ill they are.
"That is silly as the quicker the diagnosis, the better the chance of a cure.
"People's poor mobility could also be a reason but phoning patients the week before is an excellent initiative."
No, it’s a costly waste of money and yet another attempt for the state to foster dependency. Stop making excuses for people!

If you have ‘poor mobility’ and can’t get to an appointment, you ring up and reschedule.
Councillor Colin Eastwood, chairman of Newcastle Borough Council's Health Scrutiny Committee, added: "If the hospital can cut these numbers it will save money and speed up appointments for everyone else.
"I would like to think people do show a responsible attitude to their appointments and only fail to show because they have simply forgotten, in which case a quick reminder call is ideal.
"Reasons for not arriving are not always the patients' fault and some may need support to get in."
If they need ‘support to get in’, how is a couple of reminder messages going to fix this?
Outpatients directorate manager Steve Robbins said: "Missed appointments can be frustrating for staff and patients.
"I don't think many miss their appointment on purpose – it is easy to forget if it is booked far in advance.
"This new service will give patients a gentle reminder."
And when they ignore the ‘gentle reminders’? What then?

20 comments:

  1. One of the figures not given is how many of these appointments were made without the patients' knowledge.

    Members of my family have, on several occasions, missed vital appointments because the letters announcing the details were posted after the appointment date (due to secretarial or postal delays) or sent to the empty home address of a hospital in-patient - or even simply to the wrong address.

    It will be interesting to see how many people in receipt of the new reminders knew they had appointments in the first place.

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  2. Actually this seemingly pointless idea might be quite effective.

    For the reasons Macheath states and from my own experience working for a utility company in the past. We would make an appointment to go out and the customers would not be there, failure rate was far worse than 10%.

    So we tested a process like the one in this story and things improved a lot. Seems people can't be bothered to call to cancel but can be bothered to press 2 if some annoying machine rings them up.

    This tech is very cheap, the cost of a few automated calls is far less than that of a bunch of public sector workers standing idle.

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  3. I've been a no-show on at least 2 occasions. On one logged incident, I made 11 calls over 3 days ringing the number I was supposed to, trying to cancel, only to find the voicemail box full (and forget about getting a human!) or no answer at all.

    I think more people would do the responsible thing and cancel appointments if they could.

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  4. "If the hospital can cut these numbers it will save money and speed up appointments for everyone else.

    I'd have thought 10% of people not turning up would speed up appointments...?

    Sadly, my experience of hospital in the UK is that the appointments are vastly over-subscribed and your 'appointment time' is little more than a hospital in-joke.

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  5. Barman is roughly right.

    They book everybody in at the same time and deal with them as and when they can.

    It's called "convenience of the producer"; the customer's interests and preferences don't enter into the matter.

    Remember, people - if you're not paying, you are the product, not the customer; this is just another example.

    My solution - pay £10 (or £20, or whatever it takes) to have an appointment booked, returnable in full, in cash, on the day, if you turn up at the right place and time. If you don't - it's gone.

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  6. I would like 3 strikes and the hospital boss is fired. For appointments the NHS screw up I mean. In my experience they are much worse than 10%.

    Like a niece who turned up on 31st May for a scan and was sent home because the doctor wanted it done in June.

    Or the time she turned up for chemo and had to come back the next day because the notes didn't tell them which drugs.

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  7. The article itself makes a valid point that you didn't touch on, Julia: How long it takes from the date of scheduling to the actual appointment. Having lived in two socialist countries (Britain and Canada), an appointment can be upwards of 7 months after the date it's issued.

    Perhaps we'd give more of a damn if say, we weren't already dead by the time appointment day rolled round. I for one would like to see figures for THAT!

    Wendy

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  8. My private dentist texts me a reminder the day before the appointment.

    I, too, know of delayed appointment letters. This might actually be a good idea.

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  9. My private dentist texts me a reminder the day before the appointment.

    I, too, know of delayed appointment letters. This might actually be a good idea.

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  10. Nana Raft received a cross call from the hospital asking where she was, but too late in the morning for her to get to the hospital.

    Unfortunately, they had sent out an appointment (so they claimed) re-booking the appointment they had first cancelled, so all she knew was that she was waiting for a notice.

    Had they rung the day before to confirm, at least she'd have known where she was supposed to be.

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  11. Outpatients Directorate Manager.

    Another gobshite non-job that could be scrapped without anyone noticing.

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  12. I can see problems ahead for the system, especially with older patients that don't have mobile phones - how do they send a text to a land line based phone?

    Another thing, how come the much vaunted NHS takes so long between giving an appointment and the actual appointment.

    Here, in France, a friend went to see the doctor in the morning and the doc decided that a new blood test was required. The doctor called the lab and made an appointment for my friend that afternoon and another for him to return and get the results two days later - said friend couldn't make it the following day. This service is standard over here and costs are minimal and I think mainly used to make sure you need to see the doctor. Oh, and doctors do home visits as necessary.

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  13. I used to get an automated phone call for my dental hospital appointments a few days before. The calls required voice activated responses to questions like: "if you are Mr Pain-In-Molar then say yes."

    So, I said yes. It repeated the question. So I said Yes louder. It repeated. I screamed YES down the phone. It repeated. I was purple with rage and screaming YES! so loud my voice was giving out. It repeated.

    My wife took the phone. She yes, then a louder yes, then she too screamed YES down the phone.

    That's when we hung up. But when I went for my appointment I asked them not to call me on that system again.

    And I didn't have to shout.

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  14. "One of the figures not given is how many of these appointments were made without the patients' knowledge."

    Good point. Without a breakdown of reasons given for missing appointments (do they even keep records?) no-one can say what the 'solution' should be.

    "Seems people can't be bothered to call to cancel but can be bothered to press 2 if some annoying machine rings them up."

    That doesn't bode well for humanity, does it?

    "I'd have thought 10% of people not turning up would speed up appointments...?"

    Yes, but this is modern bureaucracy, where logic is turned on its head!

    "Another gobshite non-job that could be scrapped without anyone noticing."

    And they wonder why the NHS has a huge pay bill...

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  15. Joseph Ahfookyoo of Lagos2 October 2012 at 07:17

    Heh Heh Heh, ah am ver sorree dat yoo in de yoonated kindom tink de N H S is ver poor, we heah in Africa tink it is mahvelluss, tank yoo de Briteesh tax payah!

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  16. XX
    "I'd have thought 10% of people not turning up would speed up appointments...?" XX

    Not really. Because if they think they are fully booked for months in advance, then only half turn up, you COULD have had your appointment in half the time...or something like that.

    However, as they can not work on hindsight...

    There is also the times, numerous, when I have turned up only to be told the doctor is "off sick"....delicious irony, I thought. But you can bet your bottom dollar, THOSE figures will not appear in their ststistics.

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  17. FT - 'the doctor's off sick' may be clerical staff covering their tracks; my mother once travelled 40 miles to a hospital appointment only to be told the consultant had been taken ill - she later discovered that the appointment had been made for his regular weekly day off.



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  18. I once had *three* successive appointments for teeth to be removed cancelled because there was no surgeon available(!). One of these was short-ish notice, a couple of days before, and the other two were about a week and a half's notice and a month's notice. I'd been to my NHS dentist to get things started in August 2009, these appointments were for June, July and September 2010. Being in railway work I would not be able to go immediately back to work as the painkillers were not permitted in my safety critical role, so I was having to bother the management for days off each time, too - only to then call up and have to cancel the days off. In the end I gave up, went private, saw a consultant mid-August and had the teeth yanked on the 1st September (could have been sooner but those were the days is negotiated off for the third NHS booking, so decided to stick with it!). Most lingering positive feelings towards the NHS were well and truly stamped out by that point!

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  19. Macheath. Fair point, and I would not put it past them.

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  20. Most hospitals now use private companies to mail patients. They may well be on-site, but they are not nhs.
    Practically all gp services now use appointment text confirmation, if yours does not...maybe they don't have your mobile number.
    My mother had a mobile at 87.....they really are cheap.
    As for waiting time..... My gp arranged a seies of xrays and an mri scan....non-urgent.....the xray appointment took 5 days and the mri 2 weeks.
    Blood samples are done at the surgery, results back in a few days....via data directly from hospital to surgery....written confirmation by courier.
    The longest I have waited for an operation was two months (wisdom teeth removal) the shortest was one day (nasal polyps).
    Go private if you want better. Oh wait....one of virgin meds hospitals was recently slated for leaving a patient lying in their own urine. And their infection rates are no better. In most cases, if your private care goes wrong you'll end up in an nhs high dep or intensive care unit. Whoopee.
    Just because you pay directly for the teatment does not mean it is bettet. Most "private" consultants are the same ones you will see at your nhs hospital (and they may well send you to a private hosital anyway, at nhs cost)

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