Private pensions popular in UK but not in France, Germany, Spain
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GPs get a set sum per patient. It doesn't matter how many times the patient does or doesn't attend the surgery. Patients don't pay for appointments neither does the NHS. Appointments with a GP are only part of the service provided by a GP practice. How the GP organises their practice & how they organise appointments is up to them. Some practices have 8 minute appointments others have 10 minutes while a few have 15 minute appointments. It doesn't mean the last practice is seeing half the number of patients as they might see the same patients but less frequently. However it's organised if for whatever reason there are a few no shows it makes no difference to cost or funding.Parking_Eyerate wrote: »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.
As I explained earlier it's not like a restaurant where a no show really does reflect a lost opportunity cost. It's like an airline that overbooks so there are no empty seats.0 -
It really is quite simple. Medical professionals are paid to provide a service. If 5%+ of appointments are missed it relates to a wasted cost for the NHS. I tried to explain this in the context of GPs above, you don’t seem to want to talk about anything else, but ultimately contract terms and the factors defining payment do not matter. A medical professional is paid to provide a service, if the required service level could be reduced because of the elimination of missed appointments then the NHS could reduce cots.0
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No. You really don't understand how a GP practice works or is funded do you? If 5% of appointments are missed there is no cost to anyone. There is slack in the system to cover this. The GP practice is paid the same to care for an individual patient for the whole year whether the patient has 50 home visits or attends 100 appointments or books 100 appointments & only attends 95 or whether the practice doesn't see that patient from one year to the next.Parking_Eyerate wrote: »It really is quite simple. Medical professionals are paid to provide a service. If 5%+ of appointments are missed it relates to a wasted cost for the NHS. I tried to explain this in the context of GPs above, you don’t seem to want to talk about anything else, but ultimately contract terms and the factors defining payment do not matter. A medical professional is paid to provide a service, if the required service level could be reduced because of the elimination of missed appointments then the NHS could reduce cots.0 -
I believe, as I explained above, I do know how GP contracts work (I note you are still ignoring any other kind of healthcare provider). Yes, contracts are based on the number of patients but do you really believe that the NHS doesn’t give any consideration to the number of appointments patients require when they negotiate contracts? If the average number of appointments was one per patient per year then, based on having just 40 appointments a day, a single GP would only have to work the full time equivalent of 10 weeks annually to service a patient roster of 2000. Do you really think that GPs would command the salaries they do if that were the case, or do you think the NHS would pay less per contract?0
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No. You really don't understand how a GP practice works or is funded do you? If 5% of appointments are missed there is no cost to anyone. There is slack in the system to cover this.
Of course it costs the NHS more. To provide that slack requires extra resources - extra costs to the GPS, who will pass them onto the NHS as they have no where else to do so.
To use your airline analogy. Overbooking saves money compared to allowing seats to go empty, but is not itself without costs, Sometimes there are fewer thatn normal cancellations, and it is necessary to pay people to take later flights or otherwise compensate them. (I once got paid £50 for this). Surgeries can also overbook, but then somedays they have to run late and have to pay staff overtime, and get people complaining about having to wait so long.
There is a cost for missed appointments. It is inevitable that there will be some so it can't be eliminated, but it can be minimized.0
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