Missed appointments in the NHS

[sgtkate]

It is a real problem. However, if you read Freakonomics you can see a study done (corroborated by other studies too) that shows that if people are charged for things like this then they begin to evaluate it as a 'cost' rather than a penalty and some people decide that paying £20 (for example) for a missed appointment is worth the cost to them.

 

I like Obelix's idea of sending a 'invoice' so people start to see the actual costs involved. Also, in the same logic why we care more about people we know than those we don't, we often don't see the impact we cause by missing appointments or going to A&E for minor things, perhaps people who misuse NHS services get sent a really nasty letter with graphical images of people who have died or needlessly suffered as a result of a lack of resources? I still believe most people care just sometimes that 'care thought process' needs a kick start.

[Olive]

I think that's going to be too much in terms of administration work just to do that. I was thinking more that if you went in for a hip replacement then you got a "bill" saying the average hip replacement costs £4300 for theatre time and £900 for surgeons time and £500 in anaesthesia gases (have you seen the cost of sevoflurane - it's more pricy than you think!) and "900 for post operative nursing etc...

 

(please note im wildly guessing at the actual costs! I await corrections to real costs with interest)

 

I know what you meant - I do quite like the idea of clarifying the value of the service people are receiving.

 

I was thinking more in terms of a personal balance sheet for all NI services and benefits. Just for interest really. But I think on balance that idea's a dud. If we carry on reducing everyone's worth to a purely economic unit, we go down a very dangerous path.

[sgtkate]

I know what you meant - I do quite like the idea of clarifying the value of the service people are receiving.

 

I was thinking more in terms of a personal balance sheet for all NI services and benefits. Just for interest really. But I think on balance that idea's a dud. If we carry on reducing everyone's worth to a purely economic unit, we go down a very dangerous path.

 

Don't we get this already? I recently received a tax breakdown of what I'd paid and where it went. It wasn't quite granular enough to list doctors visits though, perhaps it should...

[Olive]

It is a real problem. However, if you read Freakonomics you can see a study done (corroborated by other studies too) that shows that if people are charged for things like this then they begin to evaluate it as a 'cost' rather than a penalty and some people decide that paying £20 (for example) for a missed appointment is worth the cost to them.

 

 

Good point. There is the risk that if people pay a penalty for missed appointments they may feel entitled to miss them.

 

Depends on the level the charge is set at.

 

If I remember, the example used in Freakonomics was a nominal penalty for turning up late to pick kids up from day care. When the nursery introduced charges the numbers of parents picking their kids up late went up. It was set low and people reckoned they were getting good value - late pick up, pay the charge, no guilt. Previously when there had been no charge, late-comers had just got a ticking off and tended to feel bad that they'd taken liberties, and therefore did their best not to be late.

[sgtkate]

Good point. There is the risk that if people pay a penalty for missed appointments they may feel entitled to miss them.

 

Depends on the level the charge is set at.

 

If I remember, the example used in Freakonomics was a nominal penalty for turning up late to pick kids up from day care. When the nursery introduced charges the numbers of parents picking their kids up late went up. It was set low and people reckoned they were getting good value - late pick up, pay the charge, no guilt. Previously when there had been no charge, late-comers had just got a ticking off and tended to feel bad that they'd taken liberties, and therefore did their best not to be late.

 

That's it, yup.

[onewheeldave]

 

Try and bring solutions: listing problems hardly ever gets things moving much.

 

 

On the contrary, identifying the flaws is a necessary first step in any solution process.

 

Which is why these admin issues are so prevalent today- any legitimate pointing out of issues in systems are drowned out by a host of apologists either denying the problem exists, or, claiming it's effects are being exaggerated.

 

As for solutions- here's one, make it NHS policy that patients can record all interactions with the NHS, and that such recordings can be used in any ensuing complaints procedures.

[Obelix]

On the contrary, identifying the flaws is a necessary first step in any solution process.

 

Which is why these admin issues are so prevalent today- any legitimate pointing out of issues in systems are drowned out by a host of apologists either denying the problem exists, or, claiming it's effects are being exaggerated.

 

As for solutions- here's one, make it NHS policy that patients can record all interactions with the NHS, and that such recordings can be used in any ensuing complaints procedures.

 

If you are going to immediately tar people as "apologists" for proffering a certain viewpoint contrary to you then I think it's fair to say you are just the sort of argumentative sort that gets short shrift when they tell someone they are being recorded. I'm not surprised they wont talk to you on the phone.

 

You can record a phone conversation - it doesn't need permission and you don't need to tell the other party. By doing so you are just going to put their backs up which of course is just what you want.

 

Recording the conversations isn't solving the problem or going towards solving the problem. It's a stick to beat people with when they make mistakes. You would be better off working in other ways to solve these problems - perhaps you could try the approach that works for me.

[onewheeldave]

If you are going to immediately tar people as "apologists" for proffering a certain viewpoint contrary to you then I think it's fair to say you are just the sort of argumentative sort that gets short shrift when they tell someone they are being recorded. I'm not surprised they wont talk to you on the phone.

 

You can record a phone conversation - it doesn't need permission and you don't need to tell the other party. By doing so you are just going to put their backs up which of course is just what you want.

 

Recording the conversations isn't solving the problem or going towards solving the problem. It's a stick to beat people with when they make mistakes. You would be better off working in other ways to solve these problems - perhaps you could try the approach that works for me.

You can indeed record a phone conversation, but, unless you get consent for that recording, it generally cannot be used for accountability purposes, as, without the consent of the other person, it cannot be 'published' (played to a third party).

 

So, if the recordings purpose is as an objective record of what was really said (which it is), then it is absolutely necessary to inform the person that you are recording, and, to have their consent.

[Obelix]

But if you are going back to them you are not replaying it to a third party. You can record such calls without giving notice and you are also permitted to use them verbatim in court or a tribunal.

[onewheeldave]

But if you are going back to them you are not replaying it to a third party. You can record such calls without giving notice and you are also permitted to use them verbatim in court or a tribunal.

 

Recordings can be used in some tribunals, but in others, they can't.

 

Not that my points about recordings are soley about tribunals or courts.

 

They could be be useful, for example, if played to a manager in the situation where an operator has said something untrue over the phone, and, has denied saying it (either intentionally, or, because they have genuinely mis-remembered what they said).

 

An objective recording sorts out the truth in that scenario, whereas, if the operator refused consent during the recording, it would be, technically, illegal to play it to the manager.