France imposing a fine for no-shows at GP surgeries.

Freya5

An interesting take on problems with Health system in France. Most GP practices in France are private concerns .
Why do we always have to make excuses to prevent any change.

That is not quite accurate to say they are "private concerns" in the UK sense, the relationship between the Assurance Maladie, the regional health services and the local practitioners is much more complex than that. You do pay the GP directly, but some of their funding is central. Other specialists have their own premises, so (for example) I find my own dermatologist, visit her in her clinic and pay her directly, then get the money repaid into my account.. When she refers me on to the hospital for surgery no money changes hands, it is all managed centrally. It is complicated, but you get used to it.
As to the shortages, some specialisms are difficult and some areas of the country find it hard to get GPs. We can always get a same day GP appointment, but might wait three or four days for our own doctor.

We're pretty lucky at our surgery, the previous house owner, before we moved here, told us the practice was under- subscribed. At our old address, Greater London, again at our local GPs we did seem able to get appointments on the same day if you hit the phone lines at 8.30 on the dot, well that was the case three years ago it may be different now.

It's not as if there is any excuse not to turn up, unless something untoward happens, all appointments with the practice nurse, GP, blood tests are followed up with a text. I broke my arm fairly recently, similarly follow up appointments for that in the orthopedic department of nearest general hospital, a letter was sent and physio appointments at the local cottage hospital I got a text follow up for the next one. Dentist sends a reminder text probably a day or two before. Yes I'm of the opinion some sort of forfeiture should be paid, unless there's a damn good excuse, because in not turning you're possibly denying someone else that time slot which could be filled if notice is given.

www.bbc.co.uk/news/world-europe-64216269, sorry forgot to post link.

An interesting take on problems with Health system in France. Most GP practices in France are private concerns .
Why do we always have to make excuses to prevent any change.

For those who like a bit of fun with languages, if you don't show up on a date or stand someone up, in French, it's called "poser un lapin". 🐇
The penalty for missing a doctor's appointment will be called a "rabbit tax" or "taxe lapin!" 🐰
Only in France! 🤣

Joseann

It's a little while since I was in the French system, but to my knowledge everything is done pretty much online and everything is centralised. You can book an appointment on Doctolib, you can also cancel the said appointment on Doctolib. Simple. You only actually have to talk to the individual surgery if your appointment is less than four hours away.

I think there's a clue there. GP surgeries in the UK are private businesses and seem to buy into different systems. The NHS app doesn't seem very well co-ordinated with whichever systems the surgeries operate. Maybe if there were a truly nation system it would work more efficiently.

Urmstongran

Perhaps they should help run NHS England MissA! They’d probably do a better job than Amanda Pritchard …

Have you ever work shadowed Ms Pritchard?

MissAdventure

I know hairdressers charge for non attendance, but they seem to manage their lists more effectively.

They see fewer people for far less complex reasons.

Urmstongran

I think we should try something though. A trial run of 3 months perhaps in a few GP surgeries to determine whether it would be cost effective rolling it out further. Surely the NHS cannot just continue to haemorrhage time slots (aka finances).

Who do you think should administer it? Don't you think GP surgery are already stretched enough?

A couple of years ago I received a letter to attend for my Covid booster. The letter arrived at lunch time and the appointment was for 9am that day.

I phoned the number on the letter to explain and apologise for my no show. I waited in a queue of 40 odd till I was finally no 1. I apologised and explained that the letter arrived 4 hours after the appointment time.

She said don’t worry this happens all the time. I asked her to take my name and record on my records that I had a valid reason for not turning up as I didn’t want it to appear that I just hadn’t bothered. She refused .

It's a little while since I was in the French system, but to my knowledge everything is done pretty much online and everything is centralised. You can book an appointment on Doctolib, you can also cancel the said appointment on Doctolib. Simple. You only actually have to talk to the individual surgery if your appointment is less than four hours away.

We could all get a wash and blow dry at the same time!

"Going anywhere nice this year?"

"Well, I'm not sure yet"

"Well, you'd better hurry up and decide, with the way your blood tests came out.
Just a bit off the back, was it, with a fringe?"

Perhaps they should help run NHS England MissA! They’d probably do a better job than Amanda Pritchard …

I know hairdressers charge for non attendance, but they seem to manage their lists more effectively.

I think we should try something though. A trial run of 3 months perhaps in a few GP surgeries to determine whether it would be cost effective rolling it out further. Surely the NHS cannot just continue to haemorrhage time slots (aka finances).

I expect there rea Baggs but there will also be cases (like I had once) when I'd been booked for an appointment I genuinely didn't know about. I can't have known because I was actually in with the nurse having a blood test at the same time. When I checked my online patient record I showed up as a DNA in the statistics.

If I were to be automatically fined for that, I'd have to appeal and somebody human would have to review the records. Undoubtedly, it would be shown that I wasn't a DNA after all, but it would take 20-30 minutes (probably) of somebody's time to check the records, cancel the fine and inform me. Even at minimum wage (with on costs) that's probably £10.

MissAdventure

In theory it makes perfect sense, but I think in practice it would cost more to look into complaints, mistakes, misinformation and general f* ups.

This

growstuff

Baggs

What I don't understand is why so many appointments (apparently!) need to be cancelled.

The reason I've sometimes had to cancel appointments is because they have to be made so far in advance that something else then crops up.

Recently I had a physio appointment at the GP, which was made six weeks previously. By chance I then had a diabetic eye screening and a hospital cancer appointment come through on the same day. The timings meant I couldn't attend all three, so I cancelled (changed) the one which meant I could attend the other two.

Perfectly reasonable, growstuff, but I was really meaning the appointments that don't get cancelled for valid reasons but where the patient simply doesn't turn up, what urms (I think it was) designated "DNAs* (did not attend).

There will be some of these cases where it is not the patient's fault but I gather that mostly they just can't be bothered or forget because they don't need it any more.

greenlady102

Baggs

I think dentists charge for no shows.

private dentists (and hairdressers) often say in their T and C that they reserve the right to charge for no shows. I'd be concerned that the mechanism for charging would eat up the charge, also what do you do about people who can't pay? There would need to be an appeals procedure and so on. I do like the idea but have concerns about actually doing it and think that the NHS generally (and GP's, who are not part of the NHS but are contractors, ) needs to get its house in order first.

I agree. Gp surgeries could end up having to employ another person just to administrate no shows.

Baggs

What I don't understand is why so many appointments (apparently!) need to be cancelled.

The reason I've sometimes had to cancel appointments is because they have to be made so far in advance that something else then crops up.

Recently I had a physio appointment at the GP, which was made six weeks previously. By chance I then had a diabetic eye screening and a hospital cancer appointment come through on the same day. The timings meant I couldn't attend all three, so I cancelled (changed) the one which meant I could attend the other two.

My DH has had various outpatient appointments. During the past year patient transport has not turned up and he was classed as a no show. This meant he had to wait at least another 6-8 weeks for another appointment and in the meantime his complaint has got worse!

Baggs

I think dentists charge for no shows.

private dentists (and hairdressers) often say in their T and C that they reserve the right to charge for no shows. I'd be concerned that the mechanism for charging would eat up the charge, also what do you do about people who can't pay? There would need to be an appeals procedure and so on. I do like the idea but have concerns about actually doing it and think that the NHS generally (and GP's, who are not part of the NHS but are contractors, ) needs to get its house in order first.

I'm all for fining people. Anything that is free is abused.

Thank you Baggs. Coming from you, those flowers mean a lot. Fortunately my husband is now in remission.

CoolCoco

Almost everyone has a phone or internet access these days so cancelling an appointment is not difficult, bring on the fines.

My issue with that is the length of time it takes to get through to anybody if you try ringing the surgery for any reason at all never mind cancel an appointment.
After I’ve listened to the repeated, do you know you can make an appointment by using Patches or the NHS app and it’s so much more efficient than ringing?

I hang on to be told that I’m 10 in the queue. I’m always 10th in the queue And they have multiple people manning the phones.
The whole operation to get through usually takes at least 25 minutes.
Last time I tried to do something on the Internet – changing my prescription because the tablets were having an adverse effect on me, it turned out that the Doctor who would be reviewing my prescription request was on holiday.