Despair over people failing to attend hospital slots


A TOTAL of 240 people missed hospital appointments in the three months from July to September, according to figures from NHS Shetland. Health chiefs reckon this equates to £65 per missed slot.

Missed appointments, where the patient did not notify the hospital they were not going to attend, run at more than five per cent overall and in some departments are much higher. The worst offenders are people with first appointments at the paediatric clinic where the rate of failure to attend is 21.4 per cent.

Second worst is the fracture clinic, with the rate running at 13 per cent for either new or follow-up appoint­ments. In August, 7.2 per cent of new appointments across all out­patient clinics did not bother to let the hospital know they were not going to turn up. Head of clinical services Simon Bokor-Ingram de­scribed the statis­tics, which are for clinics run by consultants either from Aberdeen or based at the Gilbert Bain Hospital, as “scary”.

Mr Bokor-Ingram said the rate of no-shows wastes a “huge chunk” of consultants’ time which can never be got back. He made a plea for people to let the hospital know if they do not intend to keep their appointments.

“We understand people can’t always make it and even if they phone up on the day it would give [staff] a bit more time to do something.

“We’re not going to be punitive and we’re not going to be angry or judge anyone. If you feel better and don’t want to see a clinician let us know so we can offer the slot to someone else. We will always try and fill them.”

He said it was frustrating when people in remote areas such as Fair Isle or Unst were waiting for ap­point­ments and with a bit of notice could have organised transport to hospital.

“We want an element of honesty between us and the patient but it’s got to work both ways.”

When a consultant was already in session, he said, there was “very little scope” to call waiting-list patients up.

Apart from the waste of time “did not attends” represent, there was also the huge waste of money.

Mr Bokor-Ingram said consul-tants come up several times a year from Aberdeen for two or three days at a time and they have fixed costs. Then there was the cost of the buildings not being used and extra administration, such as writing to GPs and arranging future ap-pointments.

In addition, clinics are held by consultants based in Shetland – three consultant surgeons, who may have booked theatre time, three consultant anaesthetists and three consultant physicians. Mr Bokor-Ingram said the provision was exceptionally good compared to other islands. These Shetland-based doctors cover in-patients and emer-gencies as well as outpatients.

Mr Bokor-Ingram said: “We’re all stakeholders and it’s not fair to the Shetland population if people aren’t using scarce resources.

“There would never be a wasted moment if we knew people could not attend, we could plan round it. The 240 people who didn’t turn up to outpatients clinics in the summer wasted days and weeks of con­sultants’ time.”

• Shetland NHS Board received nine formal complaints about hospital services and 10 about community-based services in the period from April to October.

Complaints made to practices other than Lerwick and Whalsay would be made direct and were not included in the statistics.

The greatest number of com­plaints was about dental services, including access to care and can­celled appointments for adults and for children. All the complaints were either upheld or partly upheld with the result that the system for managing cancellations is under review. Meanwhile recruitment of additional dentists is on-going.

Other complaints upheld or partially upheld included delays in treatment, complaints about diag­nosis and others where patients had not received the treatment they were expecting or there had been inadequate communication.

There were several about at­titudes of staff at the Gilbert Bain Hospital and at Lerwick Health Centre which were upheld or partially upheld, and one at Montfield which was upheld.


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