No-show patients cost NHS in Sussex £13m a year

Missed appointments are potentially costing hospitals more than £13 million a year.

Hospitals across Sussex have recorded more than 107,000 no-shows for outpatient appointments between April 2011 and the end of March.

“Did not attends” (DNAs) can have an impact on waiting lists as well as the financial cost of wasting staff time.

Health bosses believe someone not turning up can cost between £110 and £129 for each appointment.

Most trusts compensate by overbooking outpatient appointments to minimise the impact and staff with unexpected free time can fill it up by doing other jobs instead.

However, health bosses are urging people who know they are not going to turn up to let them know beforehand.

Some absences can be legitimate, with patients either not getting letters confirming their appointments on time or having to deal with an emergency.

However, many do not turn up because they had forgotten they had an appointment or did not need one any more but had not told anyone.

Online cancellation

Brighton and Sussex University Hospitals NHS Trust recorded 45,208 missed appointments, but this is an improvement on the more than 50,000 the year before.

Western Sussex Hospitals NHS Trust had 30,875 no-shows, a slight rise on the year before, while East Sussex Healthcare NHS Trust had a small drop, to 31,793.

Work done at the Brighton trust to bring numbers down includes online cancellation forms and sending patients text messages.

Western Sussex Hospitals director of performance Adam Creeggan said: “Our trust has achieved one of the lowest rates of DNAs in the country, and is sustaining that strong performance.

“The biggest single reason for that success is that we no longer simply send patients a letter telling them when their first appointment is – instead we use a call centre approach to agree all first attendance appointment times with the patient. Getting that agreement makes it far less likely that people will not attend.

Wasting time

“However, we are still looking for ways to improve still further and continue to explore options such as text message reminders to make it easy for patients to attend.”

A spokeswoman for East Sussex Healthcare said: “Non-attendance at appointments wastes the time of doctors and nurses and causes inconvenience for other patients.

“We would urge patients to get in touch with us if they want to cancel their appointment.

“That way we can use the appointment for someone else and it will also mean that our waiting times are not affected.”

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Comments (8)

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4:33pm Mon 24 Dec 12

greenpaws says...

I spend 75% of my time in bed. A large chunk of that is being asleep unexpected. This can make it difficult to attend medical appointments. When I go to sleep I don't know when I'm going to wake up or if I'll be able to make the next day's appointments in advance.

Some receptionists take a dim view of non-attendance even if you phone to apologise and to re-book. The tone is unpleasant. They then complain when one defends oneself.

People's health conditions don't fit into nice little pigeon hole appointments. It strikes me as very wierd that the very service to help unwell people condemns them with little understanding of their abilities.

The NHS needs to work with patients and understand them to meet their needs and keep costs to a minimum.

Much care is needed is understanding non-attendance.

Regarding forgetfulness, if successive government hadn't allowed for more and more responsibility to be heaped onto individuals and faster and more frequent actions to be made then people would be able to be calmer, more organised and less forgetful.
I spend 75% of my time in bed. A large chunk of that is being asleep unexpected. This can make it difficult to attend medical appointments. When I go to sleep I don't know when I'm going to wake up or if I'll be able to make the next day's appointments in advance. Some receptionists take a dim view of non-attendance even if you phone to apologise and to re-book. The tone is unpleasant. They then complain when one defends oneself. People's health conditions don't fit into nice little pigeon hole appointments. It strikes me as very wierd that the very service to help unwell people condemns them with little understanding of their abilities. The NHS needs to work with patients and understand them to meet their needs and keep costs to a minimum. Much care is needed is understanding non-attendance. Regarding forgetfulness, if successive government hadn't allowed for more and more responsibility to be heaped onto individuals and faster and more frequent actions to be made then people would be able to be calmer, more organised and less forgetful. greenpaws

4:48pm Mon 24 Dec 12

bug eye says...

maybe the nhs should see what private business is doing such as text messaging the day before appointments etc. we understand that some vulnerable or elderly people do not have modern technology, or if the patient has a condition as the previous comment, these should be highlighted for the nhs department concerned. Otherwise if there is no reasonable excuse and they have just forgot then it is reasonable to charge the patient. threat of a charge as a dentist or any other private medical professional would do should be stressed at the point of making the appoinment and upheld if there is a no show. I understand there is also an issue with patients using the NHS from abroad who are not entitled and not checked if they comply and should be charged but never are, this is bad business practice and they should be charged at the point of treatment as is done for brits abroad.
maybe the nhs should see what private business is doing such as text messaging the day before appointments etc. we understand that some vulnerable or elderly people do not have modern technology, or if the patient has a condition as the previous comment, these should be highlighted for the nhs department concerned. Otherwise if there is no reasonable excuse and they have just forgot then it is reasonable to charge the patient. threat of a charge as a dentist or any other private medical professional would do should be stressed at the point of making the appoinment and upheld if there is a no show. I understand there is also an issue with patients using the NHS from abroad who are not entitled and not checked if they comply and should be charged but never are, this is bad business practice and they should be charged at the point of treatment as is done for brits abroad. bug eye

7:16pm Mon 24 Dec 12

PETE OF QUEENS PARK says...

bug eye wrote:
maybe the nhs should see what private business is doing such as text messaging the day before appointments etc. we understand that some vulnerable or elderly people do not have modern technology, or if the patient has a condition as the previous comment, these should be highlighted for the nhs department concerned. Otherwise if there is no reasonable excuse and they have just forgot then it is reasonable to charge the patient. threat of a charge as a dentist or any other private medical professional would do should be stressed at the point of making the appoinment and upheld if there is a no show. I understand there is also an issue with patients using the NHS from abroad who are not entitled and not checked if they comply and should be charged but never are, this is bad business practice and they should be charged at the point of treatment as is done for brits abroad.
Sussex County do use text messaging in most if not all departments
[quote][p][bold]bug eye[/bold] wrote: maybe the nhs should see what private business is doing such as text messaging the day before appointments etc. we understand that some vulnerable or elderly people do not have modern technology, or if the patient has a condition as the previous comment, these should be highlighted for the nhs department concerned. Otherwise if there is no reasonable excuse and they have just forgot then it is reasonable to charge the patient. threat of a charge as a dentist or any other private medical professional would do should be stressed at the point of making the appoinment and upheld if there is a no show. I understand there is also an issue with patients using the NHS from abroad who are not entitled and not checked if they comply and should be charged but never are, this is bad business practice and they should be charged at the point of treatment as is done for brits abroad.[/p][/quote]Sussex County do use text messaging in most if not all departments PETE OF QUEENS PARK

8:13pm Mon 24 Dec 12

markiemark1 says...

So how come with all these missed appointments I regularly spend 45 mins to an hour waiting for my appointment?
So how come with all these missed appointments I regularly spend 45 mins to an hour waiting for my appointment? markiemark1

7:55am Tue 25 Dec 12

Sussex jim says...

markiemark1 wrote:
So how come with all these missed appointments I regularly spend 45 mins to an hour waiting for my appointment?
Good point. Some of us are self-employed, and waiting around for a late -running appointment means we are not earning, unlike salaried NHS staff.
[quote][p][bold]markiemark1[/bold] wrote: So how come with all these missed appointments I regularly spend 45 mins to an hour waiting for my appointment?[/p][/quote]Good point. Some of us are self-employed, and waiting around for a late -running appointment means we are not earning, unlike salaried NHS staff. Sussex jim

10:03am Tue 25 Dec 12

Morpheus says...

I wonder how much it costs businesses when their staff take time off work for hospital appointments and spend hours waiting to be seen? How they can even think they run an appointment system beats me.
I wonder how much it costs businesses when their staff take time off work for hospital appointments and spend hours waiting to be seen? How they can even think they run an appointment system beats me. Morpheus

5:54pm Tue 25 Dec 12

funkyyoyo says...

charge them
charge them funkyyoyo

1:13pm Wed 26 Dec 12

davyboy says...

maybe if we started charging the NHS for keeping us waiting, the system may improve. if your appointment is 1030am, then you should be seen within 10 mins of that time. we all take time off work to attend, thus losing pay, which we cannot get back. the first commenter makes a valid point, though, and sometimes cancellation cannot be avoided. what is galling is the fact that people just don't turn up, without telling anyone. this is ignorant beyond belief, and these people should be charged where possible. maybe, if hospitals knew people were not going to attend, they could ring others on the waiting list to see if they could attend early! not beyond the wit and wisdom of someone, surely!
maybe if we started charging the NHS for keeping us waiting, the system may improve. if your appointment is 1030am, then you should be seen within 10 mins of that time. we all take time off work to attend, thus losing pay, which we cannot get back. the first commenter makes a valid point, though, and sometimes cancellation cannot be avoided. what is galling is the fact that people just don't turn up, without telling anyone. this is ignorant beyond belief, and these people should be charged where possible. maybe, if hospitals knew people were not going to attend, they could ring others on the waiting list to see if they could attend early! not beyond the wit and wisdom of someone, surely! davyboy

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