I have decided to try to put a little back into my local corner of the National Health Service. I joined my local General Practice Patient Participation Group (PPG). 12-15 patients meet with practice staff monthly to discuss issues that are affecting patients and attempt to agree on solutions that can be implemented at the surgery level. Thus we know we aren’t going to change “The System”! 😉
My first meeting was yesterday. One topic was the (ongoing and common to general practice generally) problem of people not turning up for appointments, giving no warning. I discussed non-attendance recently on Twitter with health economists and yes, there are good reasons in some cases why this might happen – most notably isolated, ill, often old, patients who are relying on someone to transport them and who lets them down at the last minute.
However, there are undoubtedly people who have no good reason. One long-standing member of the PPG stated “we can state on the practice newsletter and notice board the number of missed appointments until we’re blue in the face and it makes no difference. We tried stating the amount it costs the practice – just shy of 70 quid per appt – and it made no difference.”
I immediately, putting my “incentives” hat on, saw another possible way to go about this. So I piped up: ‘You have patients complaining that there needs to be another receptionist/district nurse/whatever. You’re losing about 60K per annum here. People can’t put the 70 quid into context and what its real effect is upon the care they receive. So it’s time to do so.
Next time, state in bold letters across the top of the newsletter/board “The practice is short of a receptionist/nurse/whatever because of a shortfall of 60K pounds due to patients not attending appoointments with no warning.”‘
I got a very positive set of replies – “ooooh that’s fantastic, we hadn’t thought of that” – now, of course, not all missed appointments end up being a “real” cost (since the next person in the queue gets bumped up, if they’re there, and the GP decides that enough leeway has been given for “being a bit late”) but the important thing is it is of the right order of magnitude, given issues like the need to re-submit referrals (which increase the cost still further) balancing out the lower cost occasions. So let’s make it real to patients and see what happens. We’ll see if the GPs go with it.