1 million miss date with doc

June 26 2008 By EMMA MORTON Health Editor, The Sun

PATIENTS missed more than a million NHS hospital appointments in London alone last year, shocking figures show. They failed to turn up for 1.1 million – a rate of 3,200 a day. Nationwide, the problem costs the NHS £600million every year. Excuses ranged from forgetfulness to people deciding healthcare was no longer needed or appointments being on inconvenient days. But hospitals took some blame as many sent appointment letters to the wrong addresses. Last night the NHS pledged to make it more convenient for patients to cancel – using text messages and email. A Department of Health spokesperson said: "We want to make it easier for people to be able to cancel. But people have a responsibility to keep their appointments or cancel them in good time." The figures, which emerged after a parliamentary question by Labour MP Stephen Byers, revealed Lambeth Primary Care Trust was London’s worst with 69,886 missed appointments. Southwark was next on 65,630 followed by Lewisham on 63,709. Campaigner Geoff Martin, of London Health Emergency, added: "Urgent action must be taken to stem a situation where people feel they don’t need to pitch up for their allotted time, because it has a devastating effect on the ability of the service to operate effectively."
www.thesun.co.uk

Patients face fines for missed GP appointments

May 5 2008 by Madeleine Brindley, Western Mail

PATIENTS could be charged for missing a GP appointment or calling 999 for an ambulance they do not need.
The Western Mail understands that Health Minister Edwina Hart is looking into introducing a “cost system” for patients who waste GP appointments and the Welsh Ambulance Service’s time. She is also considering the possibility of publishing a leaflet which explains the costs of missing GP appointments and using the ambulance service unnecessarily. The move comes amid growing concern about the number of GP appointments wasted every year by patients who fail to turn up. And paramedics have spoken of their frustration of answering emergency 999 calls from patients who have nothing wrong with them. Some dental practices in Wales are already warning patients that missing two appointments without giving more than 24 hours’ notice of cancellation could result in them being removed from the practice’s list. It is estimated that 500,000 GP appointments and a further 260,000 practice nurse appointments are wasted every year in Wales by patients who fail to turn up. And across the UK, it has been estimated the problem costs the NHS up to £200m a year. In some group practice surgeries a week’s worth of one of the GP’s appointments can be wasted every single week. If these appointments had been cancelled they could have been released for other patients who needed to see a GP or practice nurse, improving patient access. Surveys by the health education charity Developing Patient Partnerships have suggested there is some support among GPs for charging patients a nominal fee of £10 for missing an appointment, or even striking persistent non-attenders off the register. Dr Andrew Dearden, a Cardiff GP, said: “I have a list of 7,400 patients and I suspect that I have at least five or six who do not turn up every day, day in day out. “But I couldn’t do the same as a dentist and refuse to see a patient before they pay up and I wouldn’t want to be put in that position.” Dr David Bailey, chair of the Welsh GP committee, said: “It would make great difficulties for GPs if we were to start charging patients for missing appointments. I’m not sure the same concerns would apply to misuse of the ambulance service because it is easier to define misuse and the service does not have the same ongoing relationship with patients. “We do need an education programme about the impact of missed appointments in primary care but we are not happy with the idea of charging because it raises enormous issues about inequalities and it would interfere with the doctor-patient relationship.” Paramedics in Cardiff have told the Western Mail that they regularly have to deal with unnecessary 999 calls. Examples include a patient who dialled 999 after suffering a paper cut; a man who called for an ambulance to ask paramedics to rub cream on his back; a woman who had been told by her GP that she had a bug and demanded to be taken to hospital; and a man who dialled 999 after stepping on a “foreign” bee in the early hours of the morning, but had no symptoms of an allergic reaction. Every time the ambulance service responds to one of these calls, it means that an ambulance is not available to respond to a life- threatening emergency. Each ambulance call costs about £376, which includes the cost of control, overheads, vehicles and crews. A spokesman for the Welsh Ambulance Services NHS Trust said that in 2007-08, 0.7% of calls – about 168 a month – were classified as a hoax. He added: “Although we do not receive many calls which are regarded as hoax calls or misuse of service calls, clearly any of these calls keep an emergency ambulance away from a genuine potentially life-threatening situation. “We are a busy service, and such calls only put those who genuinely need our service at greater risk. “We would welcome any initiatives to educate the public regarding our service and ensure that the calls made to us are appropriate and necessary.” Patients’ Association spokeswoman Vanessa Bourne said: “It’s interesting that the Assembly Health Minister is thinking of doing this, because it’s one of those things that has been talked about for years by the British Medical Association. “It has been a problem for years with people wasting money like this and we’re all for making the system as efficient as possible. “But the thing that works best – if patients don’t take appointments seriously – is if next time they want one the doctor says: ‘Well, we’re sorry, if you don’t take your appointments seriously, neither will we. We’ll not treat you as a priority.’ “There is nothing that works more efficiently than that. “As long as it’s possible for a patient to get in touch to say an appointment cannot be kept, I think all these different systems are fair enough, because people are taking up appointments that others could have had. “But I’m not sure how enforceable fines like this are.”
www.icwales.co.uk

 

Dentists' fury over missed appointments

23 April 2008 by Clare Semke

DENTISTS are threatening to quit the NHS after more than 16,000 patients in the area didn't turn up for appointments.
Missed appointments have cost south-east Hampshire dentists £365,000 since new contracts were introduced on April 1, 2006. The 16,282 missed appointments – more than 300 a week – are equivalent to the workload of more than three full-time dentists. Dentists can no longer charge for missed appointments, and are paid for a set number of NHS treatments every year, agreed in advance with health managers. The problem for dentists is that, if they fall well below that level of work because people do not show up, they may have to pay cash back to the NHS. Fed-up dentists are now considering leaving the NHS altogether, according to Gosport dentist and Hampshire and Isle of Wight Local Dental Committee secretary Keith Percival. He said: 'The "fail to attends" are a massive problem and a waste of time. Dentists are no longer able to charge for a failed appointment and it's extremely difficult to recover extra units of dental activity in lieu of wasted time. 'If by the end of year they are four per cent or more below their target the primary care trust can claw back the money it has paid out – which can have a devastating effect on practices. 'They may have less money to spend on equipment or staff. 'Some dentists want to leave the NHS or take on more private work because of it. The figures, which came from a survey of dentists paid for by Hampshire Primary Care Trust, comes a week after the Tories revealed that 23.2m people in Britain had not seen a dentist in the two years to last September. No figures for Portsmouth are available. Hampshire Primary Care Trust primary care dental services lead contract manager Natalie Jones said the trust urged patients to attend appointments, and to phone to re-arrange if they could not make the original date.

Contract small print
The new dental contract was introduced on April 1, 2006 and marked the biggest change in NHS dentistry since 1948. Dentists who signed up agreed with the local NHS to carry out a set number of treatments – called 'units of dental activity' – a year for a flat fee. The system guarantees NHS dentists a fixed income. Dentists who fail to fulfil their contracts can see their cash cut the next year. And those who reach the agreed number of treatments before the year is up may not be paid until the next financial year. During 2007/08 £36m was spent on appointments in Hampshire, including £780,000 on new services.
www.portsmouth.co.uk