NHS whats happened?

[loafer123]

Teddy Lop said:

Pay, and be offered an appointment time to suit, I and I'm sure many would.

Don't pay, and be batched into a window, which helps offset no-shows.

Obviously the system can be flexible, if someone doesn't have means but has the need the doc can access the system and offer them a timed next appointment.

Simples, all you need is people who want to make things work.

But hoomins.

It'll never happen.

You are describing private medicine, which is not what the proposal is designed for.

The principle is that, if people don’t turn up to appointments, they effectively pay a fine.

[Killboy]

What percentage of people don't turn up for a booking?

[chemistry]

Killboy said:

What percentage of people don't turn up for a booking?

Approx 1 in 20, apparently:

https://www.nationalworld.com/health/patients-miss...

[Teddy Lop]

loafer123 said:

Teddy Lop said:

Pay, and be offered an appointment time to suit, I and I'm sure many would.

Don't pay, and be batched into a window, which helps offset no-shows.

Obviously the system can be flexible, if someone doesn't have means but has the need the doc can access the system and offer them a timed next appointment.

Simples, all you need is people who want to make things work.

But hoomins.

It'll never happen.

You are describing private medicine, which is not what the proposal is designed for.

The principle is that, if people don’t turn up to appointments, they effectively pay a fine.

I said nothing of private medicine. I'm offering thoughts on how to schedule appointments to minimise the impact of no shows.

Without the facility to deny access fines are pretty toothless.

chemistry said:

Approx 1 in 20, apparently:

Hoomins and free sh*t. Normal rational behavioural rules don't apply.

Whatever the context, be it the builder I work for who fails to specify numbers then wonders why people want 20 sockets in every room, or a training course I was on when they brought out tea+cake and the guy stood next to me couldn't compute that I didn't want any, repeating "but it's free" with a dumbfounded look on his face.

[chemistry]

Killboy said:

chemistry said:

Unfair on the poorest? Nobody has to pay, just don’t miss an appointment (or fail to phone up and cancel with reasonable notice).

So how do you make the appointment? Pay up front and refund if you make the appointment? Who pays the card fees? Or do you get sent a bill of you miss it?

Is this even the problem for the NHS?

Appointments could remain free, but can’t be booked until fines for missed appointments are settled ie if you have an unpaid fine you can’t access GP services etc again until you pay it. A&E would use the same system, so no point going there instead unless it’s judged to be life or death by the triage team at A&E.

Yes, it’s a problem for the NHS…5% of appointments are missed, causing waste, delays, etc.

We need to change the mindset; keep the NHS free at the point of use but not at the point of abuse.

[Sway]

hairykrishna said:

pablo said:

I don't think you understand how private health care works...

I tend to agree with your point but private healthcare is likely to cost us a lot more than that. The NHS costs about 300/person/month. The US system costs them about 800.

There are plenty of examples of semi-privatised healthcare that are nothing like the US...

We do ourselves a massive injustice by only ever comparing the NHS (so amazing, no other nation has ever bothered emulating it) to the one even worse 1st World comparator of the US model.

On a couple of metrics, the NHS is (still) world class. Unfortunately, on all the actually important ones in terms of healthcare, it's pretty crap. The levels of 'failure demand' within the NHS due to it's structure and approach is absolutely unacceptable.

[Killboy]

chemistry said:

Killboy said:

What percentage of people don't turn up for a booking?

Approx 1 in 20, apparently:

https://www.nationalworld.com/health/patients-miss...

Sounds like people are trying to solve a problem that doesn't exist, and can very easily be worked around.

[Killboy]

chemistry said:

Appointments could remain free, but can’t be booked until fines for missed appointments are settled ie if you have an unpaid fine you can’t access GP services etc again until you pay it. A&E would use the same system, so no point going there instead unless it’s judged to be life or death by the triage team at A&E.

Yes, it’s a problem for the NHS…5% of appointments are missed, causing waste, delays, etc.

We need to change the mindset; keep the NHS free at the point of use but not at the point of abuse.

So who administers the whole system? The NHS now has build a booking fine system, and you need the operational capabilities to support it, making it even more administration heavy.

Here is an idea. If 1 in 20 don't show up, pad an additional booking slot for every 20 appointments? Works very well any other industry. It sure beats not being able to visit A&E when you've just had an accident because you missed a GP appointment a year ago.

[Riley Blue]

chemistry said:

Killboy said:

What percentage of people don't turn up for a booking?

Approx 1 in 20, apparently:

https://www.nationalworld.com/health/patients-miss...

Last month, at the practice I go to, 23,178 appointments were offered, 1,092 were DNAs (Did Not Attend).

[crankedup5]

pavarotti1980 said:

crankedup5 said:

Phoned my G.P. surgery for appointment and eventually got to speak to receptionist. Patients must advise receptionist why I wanted an appointment, saying stuff like because I’m ill is enough information. Our Surgery now have receptionist triage appointments. I was told no appointments available call tomorrow and try again by the computer. When I had to explain my symptoms to receptionist she told me a cancellation had just appeared and I was given a same day appointment.
Prioritisation is being determined by non medical staff.

Doctor went through rudimentary health checks and decided to refer me to hospital. Didn’t offer me a FIT test nor send me for urgent blood tests, nor offer me a prescription for which he recommended, if I want that I must pay, even though the product is on the prescription list and I am
eligible for a NHS prescription.

Now on two week cancer pathway examination/treatment program (again) which is running perfectly.

My G.P. surgery is worse than useless and is an obstruction and liability to my health care.

What prescription item is it that you must pay for and why are they saying pay for it?

The prescription item is Dulcolax which is a laxative to help me whilst I wait for my colonoscopy procedure. The doctor advised me to take this medication to help me. when I got to the pharmacy I was told that it is a prescription item.
The issue is not the cost but the service issues, it’s either available on NHS or it’s not.

[crankedup5]

Killboy said:

What percentage of people don't turn up for a booking?

I went for my blood tests a local hospital, chatting to the practitioner who said that they had 30 no shows the other day. They have four practitioners, so much lost percentage.

[crankedup5]

chemistry said:

Killboy said:

chemistry said:

Unfair on the poorest? Nobody has to pay, just don’t miss an appointment (or fail to phone up and cancel with reasonable notice).

So how do you make the appointment? Pay up front and refund if you make the appointment? Who pays the card fees? Or do you get sent a bill of you miss it?

Is this even the problem for the NHS?

Appointments could remain free, but can’t be booked until fines for missed appointments are settled ie if you have an unpaid fine you can’t access GP services etc again until you pay it. A&E would use the same system, so no point going there instead unless it’s judged to be life or death by the triage team at A&E.

Yes, it’s a problem for the NHS…5% of appointments are missed, causing waste, delays, etc.

We need to change the mindset; keep the NHS free at the point of use but not at the point of abuse.

Missed appointment due to secondary illness, accident or hot of other reasons. How is this policed
and what constitutes a reasonable excuse to miss appointment. The admin’ could be a problem.

[pquinn]

Given the quality of the booking system a lot of missed appointments can be because people just didn't get notification they were meant to go, or some detail like the date was wrong if they did get it.

[Electro1980]

chemistry said:

Killboy said:

chemistry said:

Unfair on the poorest? Nobody has to pay, just don’t miss an appointment (or fail to phone up and cancel with reasonable notice).

So how do you make the appointment? Pay up front and refund if you make the appointment? Who pays the card fees? Or do you get sent a bill of you miss it?

Is this even the problem for the NHS?

Appointments could remain free, but can’t be booked until fines for missed appointments are settled ie if you have an unpaid fine you can’t access GP services etc again until you pay it. A&E would use the same system, so no point going there instead unless it’s judged to be life or death by the triage team at A&E.

Yes, it’s a problem for the NHS…5% of appointments are missed, causing waste, delays, etc.

We need to change the mindset; keep the NHS free at the point of use but not at the point of abuse.

Are they causing waste and delays though? I have never had an NHS appointment on time. Surely people not turning up are only reducing the length of time everyone else is waiting.

Regardless, the idea that paying/fines will make people turn up completely ignores the evidence from other industries. All making people pay will do is make them feel entitled to a better service. Within days of implementing it I can guarantee we would have threads on SP&L “my doctors appointment was 10 mins late. Should I sent THEM a fine?????”.

[skinnyman]

My last NHS experience I had to go to A&E, it wasn't life threatening so I was there for 12hrs all in. Then my follow up appointment that was supposed to be within 4-6 weeks is actually in 12 weeks.

Having said all that, I have zero complaints regrading the staff. The single doctor that was working in A&E overnight was brilliant, the doctor I saw the following day was also brilliant, then the cardiology nurse I spoke to regarding the follow-up appointment was very thorough, no staff complaints at all.

[K77 CTR]

crankedup5 said:

The prescription item is Dulcolax which is a laxative to help me whilst I wait for my colonoscopy procedure. The doctor advised me to take this medication to help me. when I got to the pharmacy I was told that it is a prescription item.
The issue is not the cost but the service issues, it’s either available on NHS or it’s not.

You can buy dulcolax (bisacodyl) at tesco or over the counter

[Killboy]

Here is a wild idea: Pay nurses and doctors better, and try attract more of them?

[crankedup5]

K77 CTR said:

crankedup5 said:

The prescription item is Dulcolax which is a laxative to help me whilst I wait for my colonoscopy procedure. The doctor advised me to take this medication to help me. when I got to the pharmacy I was told that it is a prescription item.
The issue is not the cost but the service issues, it’s either available on NHS or it’s not.

You can buy dulcolax (bisacodyl) at tesco or over the counter

Indeed, but the point was t that I couldn’t get the product, it was the product is available on prescription and I qualify for free prescriptions.My/Doctor decided that although he recommended it he didn’t issue a prescription. if I wished to follow his medical advise I needed to pay for the medicine. I wasn’t aware Doctors could decide who should recieve free prescriptions?

[bigpriest]

K77 CTR said:

crankedup5 said:

The prescription item is Dulcolax which is a laxative to help me whilst I wait for my colonoscopy procedure. The doctor advised me to take this medication to help me. when I got to the pharmacy I was told that it is a prescription item.
The issue is not the cost but the service issues, it’s either available on NHS or it’s not.

You can buy dulcolax (bisacodyl) at tesco or over the counter

Depends on the amount prescribed - smaller packs can be bought off the shelf but the bigger packs are restricted to avoid abuse.

[BikeBikeBIke]

Killboy said:

. If 1 in 20 don't show up, pad an additional booking slot for every 20 appointments?

My buddy who's a GP says he uses missed appointments to catch up on admin etc. If they eliminated missed appointments he'd just book less appointments to add some slack back in.

So missed appointments are already factored in.