The problem of no-shows in outpatients and operating theatres is a long-standing one. Every now and again it makes the news like today and then, like the Loch Ness Monster, quietly dips its head under the water and disappears. Ian Powell of the Assosiation of Salaried Medical Specialists (the senior doctor’s union), makes his usual completely useless contribution:
““Every patient who does not turn up for their appointment, for whatever reason, not only jeopardises their own health but the health of other patients who miss out. It’s frustrating for specialists and surgeons.”
“In 2006, under pressure from the Government to reduce waiting times to below six months, Waitemata District Health Board began dropping from the elective surgery waiting list those patients who did not turn up for their first specialist appointments.
“But Mr Powell said he did not support “punishing” errant patients by removing them from waiting lists or fining them.
Am I the only one who thinks this is a pathetic response? Waitemata Health is being very sensible here, dropping people off the waiting list if they don’t pitch up for their first appointment. I would go so far as to drop them off the waiting list if a patient does not arrive for subsequent appointments or for their investigations or surgical procedures unless they:
- Phone before their appointment and give their apologies OR
- Provide a written excuse with supporting evidence within 10 working days OR
- They have a life-or-limb-threatening condition that must be attended to urgently.
Although Powell is right to say that this does require additional administration, it is something that must be done. About 9% of all appointments are DNA (Did Not Attend). To put that into perspective, it adds two weeks or so to your wait for your heart operation, at least 2 months extra for your hip operation and as much as six months in some areas for your prostate operation. (Note: I was told these figures by a colleague, so I can’t verify the source. But they do sound about right).
Many people who do not attend their appointment have perfectly valid reasons for doing so – sudden illness, their car broke down or their “lift” didn’t arrive. A frightening number, however, just simply can’t be bothered to turn up. Their problem isn’t worrying them at the moment, so they ignore their appointment, instead of giving it to another. One bloke told me he didn’t want to cancel in case his problem came back. When I told him that even 24 hours notice would have been helpful, he said “But what if it can back that morning?”
It would be helpful if all DHBs took a stand on this, but the hospitals seem to think the same way as Powell. “Too much administration” The patient can’t be bothered to turn up and the hospital can’t be bothered to do anything about it. Meanwhile, the health budget continues to haemorrhage all over the floor and patients die on the waiting lists every day. We need a simple rule:
If they can’t be bothered to turn up, we can’t be bothered to see them.