£12m scandal of missed hospital appointments

Money wasted on a year’s worth of no-shows could pay for 521 new nurses Long waits for a date are a key factor in the 126,000 cases last year, says BMA chief

PATIENTS failing to turn up for hospital appointments cost the health service in excess of £12m last year, the Belfast Telegraph can reveal.

Official figures show that 126,393 outpatient appointments were missed in 2018/19. The money wasted by the no-shows could pay the salaries of 521 extra nurses here.

Dr Tom Black (left), chair of the British Medical Association’s Northern Ireland Council, said the shocking statistics reveal a system operating under pressure and long waits for a date are a key factor.

“If you have patients waiting three or four years for an appointment, they are less likely to attend,” he said.

PATIENTS failing to turn up for hospital appointments cost the health service in excess of £12m last year.

Official figures have revealed that 126,393 outpatient appointments were wasted in 2018/19, the equivalent of the salary of 521 newly qualified nurses.

At the same time, hospitals cancelled more than 173,000 appointments over the 12-month period.

Alarmingly, review appointments for 133,153 patients with diagnosed conditions were cancelled in 2018/19.

The six specialities with the highest hospital cancellation rates were neurosurgery, rehabilitation, clinical oncology, paediatric neurology, thoracic surgery and paediatric surgery.

The statistics were released yesterday by the Department of Health and highlight inefficiencies and pressures in the health service as a result of budget cuts, staff shortages and a reduction in the number of hospital beds.

Dr Tom Black, chair of the British Medical Association (BMA) Northern Ireland Council, said the statistics reveal a system operating under pressure.

“Staff are working hard and we are coping with care for the elderly, emergency care, maternity, cancer and children, but that is causing elective care to slip,” he said.

“The DNA (did not attend) rate is high, but I suspect the waiting times have a part to play in that.

“If you have patients waiting three or four years for an appointment, they are less likely to attend. At my GP practice, we have same day appointments and our DNA rate is zero.

“If patients get appointments in a timely manner and know what the appointment is for, then they will generally attend, so I don’t think it is just as easy to blame patients for wasting appointments.”

Dr Black said an ongoing row over doctors’ pensions is playing a part in the rising pressures on the health service, as an increasing number of doctors are cutting working hours and considering early retirement in response.

Meanwhile, according to the figures released yesterday, the number of hospital beds in Northern Ireland dropped from 6,034 in 2014/15 to 5,830 in 2018/19. This has prompted the Royal College of Emergency Medicine (RCEM) in Northern Ireland to call on health officials to act to improve patient safety.

Dr Ian Crawford, RCEM (NI) Vice President, said: “A staggering 9816 patients spent more than 12 hours in our emergency departments in the three months from April to June this year, with unprecedented risks to quality of care and patient safety, as a direct consequence of inadequate and reducing capacity in the face of increasing demand.

“If the patients in our EDs awaiting admission to hospital beds were included in bed occupancy figures, then the bed occupancy in core specialties such as general internal medicine and care of the elderly would be in excess of 100% in most, if not all, of our hospitals when the widely accepted standard is 85%.

“The RCEM has consistently called for corrective investment to increase the number of acute hospital beds, along with staffing and the social care that are fundamentally required.

“With acceptance in other parts of the UK that an increase in the number of acute hospital beds is required, we can only hope that our Department of Health reaches the same conclusion, and delivers accordingly, as part of the review of urgent and emergency care in Northern Ireland.”

Alliance Party Health spokeswoman Paula Bradshaw said: “These annual figures make grim reading, as I am conscious that every figure relates to people in need of health care and treatment; and, also, that there is a workforce that is increasingly under severe pressure.”

“I fear these perennial rises in patient numbers and decreases in available beds are getting so far out of hand that the Department of Health now feels that the situation is beyond remedy and the staff working on the frontline feel that nobody cares about the ever-expanding pressures placed upon them.”

Ms Bradshaw said the figures highlight the need for MLAs to return to Stormont.

She continued: “The patients, the staff and their families all deserve much better than this.

“In the meantime, it is really important that everyone takes a note of the high numbers of DNAs.

“Obviously, there will be reasons why so many people did not show up, however, in this age of wide access to telephones, it should not be beyond most people to do the right thing and ring to reschedule their appointment.”

The Department of Health was contacted for a response.