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

nigelbb

LHW99 wrote: »

https://www.theguardian.com/society/2018/jan/02/patients-missing-their-appointments-cost-the-nhs-1bn-last-year

That is a newspaper article quoting the claim that 8 million missed outpatient appointments costs the NHS £1billion per year but doesn't quote the number of appointments so we don't know what percentage of total appointments that is. The flaw is that a missed appointment costs the NHS precisely nothing. It's all fixed costs so even if the doctors & nurses were to sit there twiddling their thumbs when there is a missed appointment it costs no more than if they see a patient. In fact they don't down tools when a patient doesn't attend as they see other patients for a bit longer or do other work.

[Deleted User]

The flaw is the a missed appointment costs the NHS precisely nothing.

Wow.

(Apparently this message is too short)

Silvertabby

“ The flaw is the a missed appointment costs the NHS precisely nothing.
=Deleted_User;76605417]

Wow.
(Apparently this message is too short)

Even if that were true, what about the cost of re-booking the appointment?

nigelbb

Silvertabby wrote: »

Even if that were true, what about the cost of re-booking the appointment?

There is no breakdown for the causes of DNAs. There are all sorts of reason. Some patients die, some get better, some move, some don't receive the appointment letter, some forget, some get held up on the day.

The actual extra cost of re-booking the appointment will be stamp for the letter. The claim of £1 billion being lost is just playing with figures. There is no real loss it's just that taking account of missed appointments the real cost of each appointment is a little higher than at first glance. If 100 appointments are made & the cost is £10K but only 90 patients turn up then it still cost £10K but the real cost is £10K for 90 patients not £1K lost because 10 didn't attend.

Ganga

nigelbb wrote: »

There is no breakdown for the causes of DNAs. There are all sorts of reason. Some patients die, some get better, some move, some don't receive the appointment letter, some forget, some get held up on the day.

The actual extra cost of re-booking the appointment will be stamp for the letter. The claim of £1 billion being lost is just playing with figures. There is no real loss it's just that taking account of missed appointments the real cost of each appointment is a little higher than at first glance. If 100 appointments are made & the cost is £10K but only 90 patients turn up then it still cost £10K but the real cost is £10K for 90 patients not £1K lost because 10 didn't attend.

What is the cost to the poor patients who cannot get an appointment yet other do not turn up,it is the same at our dentist where they have had to put a notice up warning patients who miss appointments without contacting the surgery.

LHW99

Ganga wrote: »

What is the cost to the poor patients who cannot get an appointment yet other do not turn up,it is the same at our dentist where they have had to put a notice up warning patients who miss appointments without contacting the surgery.

Alternatively what is the cost of paying doctors & nurses to work additional hours to make up for the extra time required to cover the patients who can't get an appointment when they should because someone who has been allocated the time doesn't turn up, and then for the additional time when the original no-show patient realises they actually need the appointment and re-book.

Parking_Eyerate

I'm not convinced your argument makes any sense, nigelbb. Did you not say earlier in the thread that more money (a greater share of GDP) should be spent on the NHS in order to cope with "increased demand"? Don't missed appointments increase demand? If there are more people to see (whether real or due to missed appointments) then it seems to me that there is an (perhaps artificially) increased demand and, on the basis that higher demand needs more money, there would hence be increased costs.


What if agency staff are employed to cover appointments that are not needed, is that not a waste? What if a missed appointment delays another person's appointment, delays diagnosis and means that more expensive/emergency care is needed? If fewer appointments are needed would fewer staff not be needed?

nigelbb

The DNA rates are constant over the years. Clinics are booked with the expectation that some appointments will be cancelled, and the gaps allow extra time for other patients.

The claim that the 5% DNA rate for GP appointments costs the NHS £216 million per year is effectively debunked in this article in the BMJ from last February https://www.bmj.com/content/364/bmj.l545

Parking_Eyerate

Just because the rate of missed appointments might be constant doesn't mean they don't have a cost.

nigelbb

Parking_Eyerate wrote: »

Just because the rate of missed appointments might be constant doesn't mean they don't have a cost.

An outpatient clinic isn't like a restaurant where a no show means an opportunity loss. It's like traditional airline ticketing where overbooking ensures there are no empty seats on the flight.