Hospitals: Missed Appointments

Health, Social Services and Public Safety – in the Northern Ireland Assembly at 3:00 pm on 19th September 2011.

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Photo of Mike Nesbitt Mike Nesbitt UUP 3:00 pm, 19th September 2011

3. asked the Minister of Health, Social Services and Public Safety what measures he intends to introduce to reduce the level of missed hospital appointments.            (AQO 326/11-15)

Photo of Edwin Poots Edwin Poots DUP

In the previous financial year, 171,740 outpatients missed their hospital appointments without cancelling in advance. They simply did not attend. It must be acknowledged that, to avoid such a waste of resources, the public have a responsibility to ensure that they cancel hospital appointments in advance when they cannot attend.

Between 2008-09 and 2010-11, a reduction of some 13,000 missed appointments has been secured. However, there remains room for improvement. The trusts have therefore implemented key initiatives to reduce the number of missed and cancelled appointments. Those initiatives include setting local “Did not attend” targets for locations and specialities with high non-attendance rates; introducing partial booking across all outpatient specialities and extending that to patients who are waiting for review appointments; developing pathways that reduce unnecessary follow-up appointments; and the production of an annual report by the trusts providing an analysis of the root causes and demographics of non-attendance, together with performance against local “Did not attend” targets. The Department and HSC Board will review those reports and take further follow-up action as necessary.

Photo of Mike Nesbitt Mike Nesbitt UUP

I thank the Minister for his answer. On the issue of key initiatives, I wonder whether the Minister has considered the use of modern communication techniques, such as mobile phone texting and e-mails. I understand that the health authority in Fife has pioneered that and was saving something like £110 for each missed appointment. If your figure of 171,000 for missed appointments is correct, we are talking about a potential saving of £17 million.

Photo of Edwin Poots Edwin Poots DUP

A pilot system was in place in the Belfast Trust between April and June, but I have to say that it had limited impact and was not particularly successful. However, I am keen to have another look at that and to maybe attempt another pilot. I recognise that an awful lot of groups with a large user base use text messaging to get messages out there, and I know that many dentists use it with their clients. So, it is something that I am prepared to look at again. There was a pilot, but it was not successful. However, perhaps we need to look at how that was implemented to see why it was not successful. I should add that there is a degree of overbooking, because hospitals know that there will be fallout and that not everybody will turn up. So, the cost of missed appointments probably is not as much as the headline figures might suggest.

Photo of Robin Newton Robin Newton DUP

My concern is very much the same as that which Mike Nesbitt raised in his supplementary question. Can the Minister tell us whether the situation with missed appointments is worse in Northern Ireland than in other parts of the United Kingdom?

Photo of Edwin Poots Edwin Poots DUP

We do not have figures for the number of missed appointments in the rest of the United Kingdom. However, the headline figure out today showing that over 170,000 appointments are missed is not satisfactory, and we need to look at what we should do about that. I think that, if you are going to attempt to do something about it, you would have to use a carrot and stick approach. We would therefore need to ensure that the public were well informed, on the one hand, about appointments and the proper use of electronic mail and text systems and, on the other, about the potential for being fined if they did not turn up. That is how dentists operate: if you do not turn up, you pay at your next appointment. If we were to challenge this, we would have to take those routes.

Photo of Michaela Boyle Michaela Boyle Sinn Féin

Go raibh maith agat, a LeasCheann Comhairle. In introducing these measures, will you take into account particular circumstances and cases, such as people with bad eyesight? Is it standard for appointment cards to have large print?

Photo of Edwin Poots Edwin Poots DUP 3:15 pm, 19th September 2011

Those issues do exist. I accept that, sometimes, when people do not turn up, it is not necessarily their fault. However, 61% of people who did not turn up for an appointment had forgotten; 16% felt embarrassed about going to the outpatient clinic; 13% did not think that it was important; and 10% tried to cancel by telephone but could not get through. Members can take from those figures that the core problem is people who fall into the categories of either forgetting that they have an appointment or not thinking that it is important. That is not good enough.