Saturday, 5 December 2015

Lazy, inconsiderate patients cost Borders health service millions


Almost 30,000 Borders patients have missed first out-patient appointments at consultant-led clinics over the last 16 years.Their apparent thoughtlessness or sheer laziness could have cost the NHS more than £4.7 million and denied many others with medical complaints or genuine illnesses an appointment slot.

These shocking statistics for NHS Borders - the level of missed appointments is even higher in most other parts of Scotland - were disclosed in a Scottish parliamentary written answer this week. It has been estimated that every time someone fails turn up to see a consultant the NHS loses £160.

MSP Nanette Milne (Conservative, North-east Scotland) asked the Scottish Government how many patients had missed (a) GP and (b) hospital appointments in each year since 1999 broken down by  individual health boards.

She was told by SNP Health Minister Shona Robison the Scottish Government did not hold information on missed GP appointments. But the minister was able to provide the figures for the number of first out-patient appointments at consultant-led clinics where the patient did not attend (DNA) in each calendar year from 1999 to 2014.

A researcher from Not Just Sheep & Rugby collated the data for NHS Borders over the sixteen years covered by Ms Robison's answer. Here are the statistics:

Year        Total appointments               DNA                 Percentage DNA

1999              24,562                             1,457                        5.9
2000              24,391                             1,448                        5.9
2001              31,525                             2,275                        7.2
2002              33,483                             2,326                        6.9
2003              26,655                             1,819                        6.8
2004              27,614                             1,780                        6.4
2005              27,770                             1,528                        5.5
2006              29,184                             1,847                        6.3
2007              29,763                             1,757                        5.9
2008              30,892                             1,759                        5.7
2009              32,462                             1,999                        6.2
2010              32,186                             2,118                        6.6
2011              31,217                             1,728                        5.5
2012              33,548                             2,034                        6.1
2013              34,296                             1,917                        5.6
2014              33,740                             1,990                        5.9

The table above means that over the 16 years a total of 29,782 individuals with hospital appointments did not turn up after being referred to a consultant. If each missed appointment does cost the NHS an average of £160 then the amount wasted in financial terms would be equivalent to £4,765,120.

The DNA percentages for Scotland as a whole were 10.1% in 2013 and 10% in 2014. It meant 164,794 appointments were unfulfilled in 2013 and 163,990 last year. The monetary losses may have exceeded £26 million on each occasion.

There have been several initiatives in recent years to reduce the unacceptable numbers in the DNA column. But it seems little progress has been made, and a minority of patients still show no sign of making sure they turn up at hospital on their allotted day.

When the 'unavailable' figures for missed GP appointments are added into the equation, the loss of scarce NHS funding will be even more devastating, but largely unnecessary. 

Health services in Scotland are predominantly efficient and effective, but when things go wrong the Scottish Government and dedicated NHS professionals are panned - particularly by the  right-wing sections of the press and media. It's as though the situation is much better in England where, we are told, many health trusts are in fact in financial meltdown, and a vast number of A&E departments fail to meet their targets despite working flat out.

But on this occasion it is Scottish patients who are included in the DNA columns of these damning statistics who should be issued with a tongue lashing and told in no uncertain terms about the financial impact they have on the cash-strapped NHS. 

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