Wednesday, 12 August 2009

More complete and utter bollocks to round off the afternoon ...

From the BBC:

No shows cost the NHS millions

Patients who fail to keep hospital appointments cost the NHS more than £600 million a year, enough to run two medium-size hospitals, data has shown.

Between 2007 and 2008, 6.5 million appointments were missed in the UK, with hospitals losing around £100 per patient in revenue...


Well, duh. If an NHS hospital 'loses' £100 in revenue, then clearly the NHS (as a centralised funding body) 'saves' £100 that it would have had to pay out to the hospital had the patient turned up, so I call that a break-even, taking the NHS as a whole.

The relevant costs/savings are:

a) The notional cost of having a doctor/nurse sit and wait for ten minutes before seeing the next patient (query - why would they do this rather than just call in the next patient, assuming that some patients turn up ten or twenty minutes early?), which could be solved by over-booking as the article suggests.

b) The notional saving of how much the treatment would have cost, had the patient turned up and been given a prescription or whatever.

I'm guessing that the true cost from (a) is neglible, if a problem at all, and in any event would be outweighed by the modest savings from (b).

7 comments:

dearieme said...

I agree; I suspect that the fuss about no-shows is mainly bombast. Anyway, if they are so costly, how about the NHS avoiding the practice of giving people less than 2 weeks notice of appointments in the holiday season?

marksany said...

I know a nurse who works in day surgery, including working the odd Saturday to keep the backlog down. A sizeable percentage of people don't show, for surgery that they asked for. The rate of now shows is significant but variable. They phone patients to try to get them in. Patients are sometimes on holiday, sometimes they got the oerstion privately, sometimes they changed their mind about wanting surgery. But hardly any phone in to cancel. Why don't they care about this? Because it's free, so they don't value it. For every twittering lefty going "I love the NHS" there are thousands taking it for granted and wasting money and delaying treatment for others by being rude enough not to pick up a phone and cancel.

Vindico said...

Surely the big issue here is how in the name of jumping f*** can a 10min GP appointment 'cost' £100?

Pogo said...

Although I too am sceptical about the estimated monetary cost of no-shows I can see a couple of areas where they generate a "cost" of some form.

The last twice that I've been for MRIs I've been seen immediately despite turning up 20-25 minutes early because the two previous punters failed to show up. That kit is expensive and the amortization thereof isn't going to be negligible, and while it's sittling there, complete with team of operators, it's costing money and achieving nowt. I'm assuming that at least some of the no-shows subsequently re-book, adding to the length of the waiting list and thus delaying treatment to others.

They should send them an invoice.

James Higham said...

Point "a" had crossed my mind too. More than that, interesting the move to blame the patient when the great wastage is in the way it is run.

Mark Wadsworth said...

Pogo, in cases like that, yes, there is a real cost (which sort of answers Vindico's question).

But they still ought to try and even it out with over-booking, or telling people if they miss an appointment they'll have to wait six months for the next slot, or taking a £20 deposit or something.

David Gillies said...

marksany is right about why there are no-shows. Charge people some nugatory, non-refundable sum like 20 quid a pop to see their GP and there'd be a lot less of it.