Revealed: Newham Hospital’s huge £6m bill for missed appointments
PUBLISHED: 13:49 28 April 2016 | UPDATED: 17:38 28 April 2016
Missed appointments at Newham University Hospital cost the NHS £6million a year and have a huge knock-on effect on patient care. But why do 104 patients every day fail to turn up, wasting £160 a time? EMMA YOULE reports
Two years ago Tina Dugard was forced to cancel a hospital appointment when her 90-year-old mother was rushed to A&E, but found herself penalised for the emergency.
The charity worker called Newham University Hospital, where she was due to see a specialist about a lung condition that affects her everyday life, to ensure NHS time and money were not wasted.
Yet she was marked down as ‘did not attend’ and has been unable to get a referral back ever since.
“I really don’t think they cared about any distressing circumstances, whoever took the call just neglected to register my cancellation on the system,” said the 50-year-old, who suffers from chronic obstructive pulmonary disease (COPD).
“And once they’ve struck you off there’s no way back other than waiting months for a new referral through the GP.”
Her case shows the tough stance the NHS is taking over missed appointments, which cost the cash-strapped health service £225million a year and have a knock-on effect on patient care.
A Recorder investigation has shown 38,000 appointments annually - or 104 every day - are missed at Newham University Hospital, costing an estimated £6million every year.
It is money the NHS can ill afford and Newham Hospital has appealed for the public’s help to tackle the issue and reduce waiting times for other patients.
What is Newham Hospital doing to tackle missed appointments?
The Recorder asked Alex Forster, head of outpatients at Newham University Hospital, about the issues.
How do missed appointments affect patient care?
They reduce a patient’s access to care as well as taking up valuable clinical time that could be used for other patients.
What systems are in place to reduce missed appointments?
We have set up ‘straight to test’ appointments in some services, to reduce the number of appointments people are required to attend, and implemented electronic booking of urgent referrals, such as where cancer is suspected.
We also send patients text messages and call them to remind them about the importance of attending.
Some hospital departments have higher level of missed appointments, why?
We have been contacting patients to understand why they did not attend. For example, in obstetrics (specialising in pregnancy and childbirth), lack of child care arrangements or the availability of a partner to attend were leading reasons.
As a result, the team are introducing a call reminder service days before the appointment, to compliment the text service, to help support women to make alternative arrangements.
Why is it important to get in touch if you can not attend?
This is vital in enabling us to offer the clinician’s time to another patient.
How can people get in touch to cancel?
Depending on the service, options include online forms, email and calling a dedicated phone number, 020 7767 3200, which is open from Monday to Friday from 8.30am to 5pm.
Alex Forster, head of outpatients, said: “We are aware that some patients fail to attend their scheduled appointments which, importantly, reduces their access to care as well as takes up valuable clinical time that could be used for other patients.
“We rely on people contacting us as soon as possible to advise if they cannot attend an appointment.
“This is vital in enabling us to offer the clinician’s time to another patient.”
The hospital says it is working to improve administration systems and is using technology, such as text message reminders, to reduce non-attendance.
But Miss Dugard, of Custom House, says the system is not efficient or joined-up enough.
She works as a manager and patient advocate at the charity Cancer You Are Not Alone, in Manor Park, and also rearranges appointments on behalf of others.
“More than once I have phoned on behalf of one of our cancer patients to cancel or reschedule an appointment, especially when they are hospitalised elsewhere or have clashing appointments, only to have them marked as ‘did not attend’ and threatened with discharge,” she said.
“They need to improve the services at the hospital’s end as well as blaming it on the patients.”
Health chiefs say a vast number of appointments are wasted simply because people forget to attend.
This forces hospitals to overbook clinics and can lead to longer waiting times for other patients.
Newham Clinical Commissioning Group, which oversees healthcare in the borough, called on the public to take the issue seriously.
“We know that every year, thousands of people fail to turn up to hospital and GP appointments and that missed appointments place a drain on NHS resources,” said a spokeswoman.
“If you have an unwanted hospital or GP appointment please cancel or rearrange in advance as this could help to free up an appointment for someone who really needs it.”
HOW DOES NEWHAM UNIVERSITY HOSPITAL COMPARE TO OTHERS?
About one in 10 hospital outpatient appointments nationally are missed every year in England.
The Recorder looked at data from 11 hospitals in north and east London.
We found that all had non-attendance rates higher than 10 per cent.
The figure at Barts Health NHS Trust, which runs Newham University Hospital, was 15 per cent.
The number of missed appointments is also on the rise.
Most of the hospitals showed lower rates of attendance in 2014-15 than in the two years previously.
This was also the case at Barts trust, where missed appointments have increased by 3.5 per cent in three years.
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