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£10 fine for an NHS no-show, says Rishi Sunak

Be like Sweden. Charge the fee upfront on the visit.

29 thoughts on “No.”

  1. I would say charge £10 every visit, £20 for a missed appointment, however the usual NHS problem of not bothering to collect the money would arise.

  2. What KevinS says. The usual suspects would run up huge bills and any attempt to collect would be met with rentamob and screaming headlines in the progressive press.

  3. The problem is that they would have to give a benefit (vouchers?) for people on benefits, and that wouldn’t penalise no-shows. It would be interesting to understand the demographics of no-shows but perhaps doing that would be racist or something.

  4. Stop the NHS making appointments that the patient didn’t ask for.

    I had to complain to the CEO of my local trust to stop a clinc harrassing me.

    As usual, politician sees a nail and hits with a hammer instead of pulling the stupid thing out.

  5. Is a GP ever waiting for the next patient? Because if not, what is the cost to the NHS? I’ve never walked into an empty waiting room, with the GP stood around waiting for the next person to see.

    This whole thing about missed appointments is purely to deflect from how shit the NHS is. It’s not garbage because of mismanagement, it’s the patients’ fault, see?

  6. Appointment at 08:00 on a Monday morning.
    Letter informing me of appointment printed on the Tuesday, postmarked Wednesday, delivered by 2nd class post Friday.
    So I get notified of an appointment 4 days after it has happened,and they want to charge me £10 for a no-show?

    Good luck with that.

  7. BlokeInTejasBackInNormandyForABit

    What a bizarre situation.

    I communicate with my GP (in Texas) by posting messages on the GP-provided ‘Patient Portal’. Can book appointments etc that way.
    They post the results of things like blood tests there too. Same thing with specialists.

    Hasn’t the internet yet come to Blighty? Still using pigeons to carry messages or wot?

  8. Bloke etc etc

    Throughout the first 20 years of the millennium the NHS was the worlds largest purchaser and user of fax machines.

    NHS England and GPC England expect practices, where feasible, to be making progress in 2019/20 towards meeting those requirements. The use of alternatives to facsimile (fax) machines for NHS and patient communications is listed in the GMS contract 5 year framework and the associated guidance that supports the LongTerm Plan

    Anecdotal evidence suggests that this has yet to be accomplished.

    20 years ago a plan was out in place, however……

    In 2002, the UK government launched development of the National Programme for Information Technology (NPfIT) NHS Care Records Service, which was intended to deliver an electronic health records system containing patient records from across the UK. There were problems with poor user requirements analysis, the failure to address patient confidentiality, overambitious timescales, and enormous cost overruns. It was eventually closed down in 2011 as part of the dismantling of the NPfIT programme.

    And that’s why, in all probability, the “envy of the world” still uses faxes.

  9. About 5 years ago Mrs Nerd went for treatment at a medium-sized hospital. They concluded they couldn’t fix her, and sent her on to a big teaching hospital, to be treated that day.

    They didn’t need no stinkin’ faxes.

    They wrote a letter and printed it out.

    When we got to the big hospital, the A and E triage bloke typed it into the big hospital computer. And he didn’t seem remotely surprised by the need to do so.

  10. Way back when, if I showed my UB40 card to the dentist there was no charge, if not there was a charge. I tended to time my contracts to be signing on when I went to the dentist.

    I don’t know if the same process exists, years ago I gave up signing on between contracts as the JC have a catestrophic inability to cope with modern work patterns.

  11. I don’t have experience at the hospital level, but at the GP practice level the Big Three clinic systems software companies are working just fine with patient data interworking without government dictat or design, thank you very much. Worked perfectly fine during the mass Covid vaccination program with vaccination centres being able to check patient data and send back an update to whichever GP practice the patient was registered at. It was an interesting project to work on.

  12. jgh

    It’s often inside the practise that things go wrong. I had a letter with some test results which I scanned in and e-mailed to the surgery with instructins to send them to Dr Crippen. Instead it was forwarded to the duty sawbones who had no idea what it was about and said “Righto, keep taking the tablets.” I then got into a row with Crippen, because I never sent him the mail that I had promised.

  13. @Ottokring: took my mum to her ophthalmologist a couple of months ago, she was offered a cataract operation though the ophthalmologist was Frank it would not make much, if any difference, so it was politely declined and she was discharged with a referral to the Low Vision Clinic instead.

    A week or so later, a text pings into my phone – an appointment for her for cataract surgery. Odd, a I’d watched the ophthalmologist tick the box to say it had been declined. No mind, I thought, I’ll ring them and explain.

    It took FIVE WEEKS to get it cancelled with confirmation that it was cancelled – calls and emails that went unanswered, online forms that were never processed, voicemails left that were never replied to. If I hadn’t persevered out of sheer bloodmindedness, she’s have gone down as a no show…

  14. Bloke in North Dorset


    My GP practice has a portal where I can reorder prescriptions, see my medical records etc. Prior to the great Covid lockdown I could even book appointments and choose which doctor I wanted to see.

    Unfortunately we now have to go through the gatekeeper, to see a gatekeeper. I did have a pleasant surprise last week though. My dentist suggested my GP have a lump on my tongue, when I rang at about 9:30 am and explained the problem I was given an appointment for 11:50 that day. (No problem, just precautionary).


    There was quite a stir in Germany at the start of lockdown when it came out that a lot of the German healthcare system relied on faxes. I wouldn’t be surprised if the still do.

    On a recent episode of the (not very) Easy German podcast one of the presenters was complaining that she’d forgotten a pin number and when she rang her bank they said she had to write a snail mail letter. When nothing happened after 10 days she rang again they relented and said she could use a fax.

  15. Excellent idea. This will cost those lazy bastard doctors a fortune. They never show up on time for an appointment. That’s if you can even get an appointment of course.

  16. In my lifetime I have never missed an NHS appointment that they had notified me of in good time.

    But I have several times been berated for failing to attend an appointment that they had failed to tell me about. And I once had to bark at a moronic nurse who had managed to book me two appointments at the same time at opposite ends of our humungous hospital.

    I wonder why the NHS finds it necessary to tell us not to lose our tempers with their staff. I know, it’s because too many of them are lazy, obstructive dunderheads.

  17. When I retired two and a half years ago the company that I worked for still had a fax machine. It was a little cheap one that they needed to communicate with companies that still use them.

    From when I joined the firm in 1985 to when the firm relocated in 2009 there was a sign up in the post room that said “Stop! can it go by telex.”

  18. By the way,in my above post I performed some misgendering. My Dr Crippen was in fact a lady doctorette, but I couldn’t think of a notorious enough one to name her after. Apart from Jill Biden, natch.

  19. Only recently worked with a quasi government agency involved in healthcare and when I asked about all the fax machines they said the governing legislation defined methods of communication for medical information and they couldn’t go to online systems until it was updated. In fact they had to turn off functions when upgrading some systems as they weren’t legally allowed to use them.

  20. They are more than welcome to implement this if I also receive £10 from the practice for every consecutive day (optionally increasing by £10/double for each subsequent day) I cannot get an appointment, because they have limited slots and you can only book for one on the day.

    Phone lines open at 8am, no more slots happens around 8.10am

    And is a contributory factor to our local A&E being overwhelmed.

  21. Interesting Julia. Evidently the NHS make sure that all their blunders are attributed to the slackness of the patients. And Rishi’s looked at the overall figure and said, ‘Here’s a nice little earner.’

    Of course if it really happened the Tim the Coder problem would force itself to the fore.

    Thus there’s no doubt that Tim W’s solution is the best. Charge the fee upfront on the visit.

  22. Sorry Julia, I forgot to respond earlier.

    Sometimes a “no show” is the only way to make them listen.

  23. Oops TtC. I meant if the ten quid charge really came in. I didn’t doubt you’d had a late notification.

  24. @Bloke on M4 – “Is a GP ever waiting for the next patient? Because if not, what is the cost to the NHS?”

    That depends on how people cope with missed appointments and whether the GP is paid for a no-show. If not, and a GP knows that on average two of their patients a day will be no-shows, they may therefore books appointments for two more than there is time for, we get two bad effects. Firstly, if today’s patients all appear, the GP has to work late or cancel the last two appointments of the day (like with airlines overbooking flights). Secondly, since the GP cannot know which two won’t appear, they need to tell everyone to arrive early enough to ensure that there is always a patient waiting when there is a no-show. That means that most of the time patients have to waste their time turning up only to have to wait. This is likely to make patients lose respect for appointment times and turn up late to avoid some of the waiting, which has a similar effect to no-shows, making all later patients have to wait even longer. A vicious circle ensues with GPs asking patients to turn up ever earlier in an attempt to avoid wasting their own time at the cost of wasting the patients’ time.

  25. This will be turned into cash cow by NHS. Below four examples I’ve had

    1 Appoinment changed from 16:00 to 10:00, letter arived on the day After new time. Lengthy battle to have “Failed To Attend {FTA) removed

    2 Appointment letters never sent/received

    3 Phone to cancel/change appt – phone never answered

    4 Letter says “call number below to…” – no phone number

    Email a cancelation? Maybe in “You Must Go Digital, but we won’t yet” 2122

    Other than 4, no way to prove innocence as it will be another ‘Guilty until proved innocent’ law

    Good example of NHS incomptence in this YT comment:

    “I attend one of the hospitals under the umbrella of the Royal Free. You can go online and fill out a short form to cancel or reschedule an appointment. It just so happens I recently had to follow this procedure to reschedule because of an illness.

    A couple days after original appointment I received through the post from the Royal Free a new appointment letter. However…the heading of this letter was “You Failed To Attend Your Appointment”. Well I thought there was a difference between informing them and simply failing to attend. My point is…there’s a ticking box’s scam going on to yet again blame the public for the mess the NHS has put themselves in.”

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