Private pensions popular in UK but not in France, Germany, Spain

Parking_Eyerate

There is an opportunity lost for someone, someone who then has to wait longer for an appointment that could in turn mean waiting longer for a referral, longer for a diagnosis and longer for important treatment, which could possibly mean more expensive treatment.


The article you linked to even suggests that the rates in hospitals are 10%. If even a fraction of that 10% could be saved in the manhours of some staff it could be a significant sum. The author also didn't actually present any arguments as to what the cost was, just indicated he didn't believe the figures. I also note that one of the commenters (from a GP practice) said they didn't schedule appointments assuming some would be missed, so the approach you suggest is not universal.


To me it simply isn't realistic to assert that there isn't a cost related to missed appointments.

nigelbb

Parking_Eyerate wrote: »

There is an opportunity lost for someone, someone who then has to wait longer for an appointment that could in turn mean waiting longer for a referral, longer for a diagnosis and longer for important treatment, which could possibly mean more expensive treatment.


The article you linked to even suggests that the rates in hospitals are 10%. If even a fraction of that 10% could be saved in the manhours of some staff it could be a significant sum. The author also didn't actually present any arguments as to what the cost was, just indicated he didn't believe the figures. I also note that one of the commenters (from a GP practice) said they didn't schedule appointments assuming some would be missed, so the approach you suggest is not universal.


To me it simply isn't realistic to assert that there isn't a cost related to missed appointments.

Perhaps it's because you don't understand how either hospital outpatients or GP surgeries work?

A GP will see 40-50 patients per day so if a couple of thosepatients don't arrive for their appointments it is neither here nor there it probably just means the GP gets to finish on time. There is no loss to the NHS. The GP doesn't get paid a fee for each patient attendance.

Likewise with outpatients there is enough flexibility in the system to ensure that no time is wasted & again no money is lost.

Parking_Eyerate

You can mock my understanding all you want but I still think your argument is simplistic and inaccurate.


https://digital.nhs.uk/data-and-information/publications/statistical/appointments-in-general-practice/oct-2018


According to the raw data in the survey (I've tried to post the link above but I'm not sure if it will work), on Saturday the 6 October 2018 I believe that there were about 220,000 scheduled face to face appointments which had been booked in advance (were not listed as same day appointments). In the working week leading up to that (Monday 1 to Friday 5 October 2018) there were about 5.5 million appointments. Using the 5% rate (though I also note that the attendance rate only seems to be around 90% on average, so perhaps 5% is a significant underestimate), approximately 275,000 of those 5.5 million appointments were wasted. Had the 220,000 scheduled for a Saturday appointment instead been able to have a weekday appointment then it is possible that huge savings could have been made (by not having to pay as many people to work on Saturday, for example).


Of course, it might not always be possible to avoid paying staff for Saturday (and Sunday) appointments but I don't see why numbers couldn't be reduced, and money saved, if there weren't so many missed appointments.

nigelbb

Parking_Eyerate wrote: »

You can mock my understanding all you want but I still think your argument is simplistic and inaccurate.


https://digital.nhs.uk/data-and-information/publications/statistical/appointments-in-general-practice/oct-2018


According to the raw data in the survey (I've tried to post the link above but I'm not sure if it will work), on Saturday the 6 October 2018 I believe that there were about 220,000 scheduled face to face appointments which had been booked in advance (were not listed as same day appointments). In the working week leading up to that (Monday 1 to Friday 5 October 2018) there were about 5.5 million appointments. Using the 5% rate (though I also note that the attendance rate only seems to be around 90% on average, so perhaps 5% is a significant underestimate), approximately 275,000 of those 5.5 million appointments were wasted. Had the 220,000 scheduled for a Saturday appointment instead been able to have a weekday appointment then it is possible that huge savings could have been made (by not having to pay as many people to work on Saturday, for example).


Of course, it might not always be possible to avoid paying staff for Saturday (and Sunday) appointments but I don't see why numbers couldn't be reduced, and money saved, if there weren't so many missed appointments.

This discussion didn't start off talking about saving money. It was the claim that missed appointments cost the NHS £1 billion per year. I've just been demonstrating that this is a pointless playing about with figures & that no loss is incurred.

Since we moved on to GP appointments let's consider a normal day. The GP has 50 patients booked in for appointments but only 48 turn up. All costs are fixed so there is no loss. Let's assume the fixed costs for staff, buildings etc are £2500. That doesn't mean each appointment costs £50 so two missed appointments means a loss of £100. What it really means is each that appointment actually costs £52.83.

Parking_Eyerate

If appointments have to take place on weekend days when they otherwise could occur midweek there are additional costs incurred, e.g. weekend staffing.

nigelbb

Parking_Eyerate wrote: »

If appointments have to take place on weekend days when they otherwise could occur midweek there are additional costs incurred, e.g. weekend staffing.

GP costs are fixed & there is no extra for weekend working. Building costs are fixed. Very few GP surgeries offer weekend appointments. I doubt that any offer weekend surgeries to accommodate people who couldn't get an appointment during the week because of 5% no shows.

Parking_Eyerate

I take it from your assertions that the NHS never, ever pays locums or any self-employed healthcare providers to provide appointment services based on hourly or sessional contracts. That is unbelievable.

nigelbb

Parking_Eyerate wrote: »

I take it from your assertions that the NHS never, ever pays locums or any self-employed healthcare providers to provide appointment services based on hourly or sessional contracts. That is unbelievable.

If a GP employs a locum the cost of the appointment to the NHS doesn't change. The GP practice is paid to provide a service to a particular catchment area. They don't get paid per appointment or per attendance. I don't think you understand how NHS finances operate.

[Deleted User]

nigelbb wrote: »

If a GP employs a locum the cost of the appointment to the NHS doesn't change. The GP practice is paid to provide a service to a particular catchment area. They don't get paid per appointment or per attendance. I don't think you understand how NHS finances operate.

Good news: NHS Director and the Chair of Royal College of GPs don’t understand anything about NHS either: https://www.england.nhs.uk/2019/01/missed-gp-appointments-costing-nhs-millions/

I commend the valiant effort of trying to prove that 2+2=5

Parking_Eyerate

You are notably focussed on straightforward GP surgeries, I guess because you might have direct experience of one. Healthcare appointments cover a lot more than basic GP practices, however, including medical practitioners that are paid on an hourly/sessional basis, which you conveniently seem to ignore.

Nevertheless, to appease you and focus on GPs I will try to illustrate the point in a different way.

If GPs are compensated by the NHS on a GMS contract that pays per patient, then missed appointments clearly represent a cost burden to the NHS. For example, if a GP practice has about 2000 registered patients and 5% of appointments are wasted (though again it is noted that could be a very generous estimate), then the GP is effectively being paid to provide services to 100 more patients than they actually cater for. Just because the NHS pays out public money doesn’t mean it isn’t wasteful to pay for a level of service that isn’t provided because of missed appointments. If GPs were able to save the wasted time from missed appointments then they could improve their organisational and accountancy practices and reduce contract costs, reducing NHS costs. Put another way (and approximating based on numbers above), NHS contract negotiators could require a list of 2100 in order to qualify for payment for 2000 patients.

It simply does not make sense to pay people to not provide services, which is the ultimate outcome of a missed appointment.

I don’t think you understand maths or economics.