Should people be fined for wasting GPs / Hospital's time?

Guinness Boy · Jun 18, 2015

Out last night with friends. One couple belonged to the GPs surgery in Hove that has just been shut down. We had a fairly long chat about that and about the NHS in general. There was a general consensus that the NHS was underfunded, that A&E waiting times and practices were unacceptable, that 10 minutes can sometimes not be enough for a doctor to assess you properly and that there are too many no shows (without cancelling to free up the spot). Also people going in because they have a cold or need a prescription for something they should buy.

Given that the NHS should be free at the point of care do you agree with the Health2020 proposal from a few years ago that people should be fined for wasting doctors' and hospitals' time with that money going straight back in to NHS funding? Should it perhaps be easier for Doctors to strike off patients (currently they have to demonstrate that the mutual relationship has broken down)? Or, even more radically should GPs charge a fee or deposit? Or do we risk handing over a financially punitive decision to a group of people who told a teenage cancer patient to stop googling her symptoms?

Well?

Badger · Jun 18, 2015

The trouble is it will lead to some people not going to see a doctor even if they have a genuine reason, because they will be worried about getting fined. Being fined for failing to show up seems fair enough though, it's selfish and rude IMO.

Mattywerewolf · Jun 18, 2015

said charge for appointment - agree with Badger this should be for no shows or obvious cases of time wasting (e.g. broken nail)

http://www.bbc.co.uk/news/uk-england-kent-13528444

Westdene Seagull · Jun 18, 2015

Only if I can charge the NHS when they waste my time. Oh, and actually allow me to actually use the service how I wish to. A prime example being that when I want to get a doctors appointment I have to ring up at 8am and see if they have any spots left for that day. They won't allow me to make an appointment in say 3 days time.

Cadiz Seagull · Jun 18, 2015

Airlines have a check in time, if you aren't there by then you lose the flight and any stand by customers get it instead. Therefore airlines overbook as they know x% are not going to show.

I'm sure it's not beyond someone's capability of adapting this system to deal with no shows on the NHS

Badger · Jun 18, 2015

The main BARRIER I find to making an appointment with a doctor is having to INTERACT with a receptionist. I swear they try and employ the most miserable and UNHELPFUL people who seem to be on a mission to make you feel GUILTY about using up their VALUABLE time.

happypig · Jun 18, 2015

First reaction is to say "yeah, fine them for missing an appointment" but thinking further, there are a lot of reasons people miss appointments so you'd need an appeals process and this would probably add more bureaucracy and costs to the whole system. Secondly, would you fine someone on benefits (who tend to have more health issues) the same as someone earning 50k a year ?
One thing that might work is for the surgeries to have a list of serial non-attenders & time-wasters and only give them appointments at the end of surgery (so, for example, people on the list would be told to turn up at 11:00 and they are seen in order of arrival, once the waiting room is empty, surgery is over and the doctor can do his other stuff).

brightn'ove · Jun 18, 2015

Westdene Seagull said:
Only if I can charge the NHS when they waste my time. Oh, and actually allow me to actually use the service how I wish to. A prime example being that when I want to get a doctors appointment I have to ring up at 8am and see if they have any spots left for that day. They won't allow me to make an appointment in say 3 days time.

Burwash road? I had to leave them, utterly atrocious surgery.

Westdene Seagull · Jun 18, 2015

brightn'ove said:
Burwash road? I had to leave them, utterly atrocious surgery.

Nope, Hangleton Manor. My partners surgery in Shoreham has had the booking system for years and it frustrated her so much getting appointments that she was going to move to my practice. Sadly my practice has just introduced it - according to the manager it makes it easier for people. Like hell it does if you work !!!

WATFORD zero · Jun 18, 2015

Westdene Seagull said:
Only if I can charge the NHS when they waste my time. Oh, and actually allow me to actually use the service how I wish to. A prime example being that when I want to get a doctors appointment I have to ring up at 8am and see if they have any spots left for that day. They won't allow me to make an appointment in say 3 days time.

Wasting a Business Consultants time. Are you familiar with the term 'Oxymoron' ? :wink:

brightn'ove · Jun 18, 2015

Westdene Seagull said:
Nope, Hangleton Manor. My partners surgery in Shoreham has had the booking system for years and it frustrated her so much getting appointments that she was going to move to my practice. Sadly my practice has just introduced it - according to the manager it makes it easier for people. Like hell it does if you work !!!

It's disgraceful. The problem I had was being told that you couldn't under any circumstances book an appointment in advance, then calling up at 8am to be told that there were no appointments available! The receptionists also insist that you tell them what is wrong with you ... like it's their ****ing business. Very very glad I moved - can book an appointment very easily now and the staff aren't complete c***s - i just hope it doesn't go the same way.

Guinness Boy · Jun 18, 2015

happypig said:
One thing that might work is for the surgeries to have a list of serial non-attenders & time-wasters and only give them appointments at the end of surgery (so, for example, people on the list would be told to turn up at 11:00 and they are seen in order of arrival, once the waiting room is empty, surgery is over and the doctor can do his other stuff).

Actually I'd forgotten (we'd had wine and gin) but that was another idea we discussed last night and there seemed more agreement about it round the table than anything else.

Personally I voted to make it easier to remove problem patients from the register. A ringfenced system of fines sounds ok when you first say it out loud but, as you point out, it would have to make a practical profit and be administered by "someone" - that someone presumably being either the GP themselves, the Receptionist / Dragon or someone like ATOS!

fat old seagull · Jun 18, 2015

One anomaly that crosses my mind whilst watching my life go by, sitting in my GP's waiting room. The board on the wall that advises us that there were any huge number of missed appointments last month....well, I ask myself if this is so, why do I never get to see my Doctor at the designated time. Surely when someone fails to turn up he doesn't spend that time playing Sukudo!!!!

symyjym · Jun 18, 2015

Badger · Jun 18, 2015

brightn'ove said:
It's disgraceful. The problem I had was being told that you couldn't under any circumstances book an appointment in advance, then calling up at 8am to be told that there were no appointments available! The receptionists also insist that you tell them what is wrong with you ... like it's their ****ing business. Very very glad I moved - can book an appointment very easily now and the staff aren't complete c***s - i just hope it doesn't go the same way.

My surgery used to have a similar system, on a couple of occasions I had to turn up outside at 8am and join a queue of people to get one of the early slots. It was ridiculous and you'd end up either waiting another half-an-hour to be seen, or be told you were too far back in the queue but we've got an appointment slot at 4pm. Thankfully they completely changed the system a couple of years ago, so you are usually able to book a few days in advance or get a same day emergency appointment.

symyjym · Jun 18, 2015

61,000 people miss their GP appointments every day, so if one is not cancelled in advance, a nominal, non wavetable, £3 charge should be applied. Until they pay the £3 they cannot make another appointment.

happypig · Jun 18, 2015

symyjym said:
61,000 people miss their GP appointments every day, so if one is not cancelled in advance, a nominal, non wavetable, £3 charge should be applied. Until they pay the £3 they cannot make another appointment.

The problem with this (and I dont disagree with your sentiment) is twofold: some people don't have a spare £3 and if they were blocked from their GP they'd just pitch up at A&E or call an ambulance.

Surf's Up · Jun 18, 2015

Inapproriate attendances (eg for colds, cuts and bruises etcetc) at A&E and GP surgeries and not attending GP or outpatient appointments are one of the biggest causes of NHS inefficiency and additional cost. It is difficult to maintain the principle of "free at the point of delivery" if fes or fines are introduced but this may well be the only way of overcoming these problems which the NHS has failed to resolve for years.

Surf's Up · Jun 18, 2015

sorry ... for "fes" read "fees"!!!!

Spicy · Jun 18, 2015

They should charge people who miss appointments like they do at the dentist. Problem is there is a system in place for paying the dentist whereas there isn't at the GP's surgery, although I paid for a private medical once and they took my money easily enough. Presumably at the dentist if you miss an appointment they just tack the charge onto your next bill, but wonder how easy it would be to administer this at GP surgeries. I had to go to the doctor yesterday and was seen before my slot so unsure what happened to the person before me. Maybe they were a time waster or just didn't turn up!

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Should people be fined for wasting GPs / Hospital's time?

How should we deal with time wasting patients?

Fine for wasting time

Charge for appointment

Just make it easier to strike off

Leave it as it is

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