One in six patients fails to show for hospital clinics

Patients failed to attend for one out of every six hospital appointments made in the health system last year, new figures show.

Almost 500,000 outpatient appointments resulted in a “did not attend”, resulting in huge financial costs for hospitals and delays for other patients, the figures show.

Patients failed to show for 139,000 of 923,000 new appointments made, and for 349,000 of 2,375,000 return appointments, the figures from the Health Service Executive reveal.

“Did not attend” rates continue to run at 15 per cent despite repeated promises by politicians and health service managers to crack down on patients who fail to turn up for scheduled appointments.

Even in cancer care, 7 per cent of outpatients fail to turn up for appointments.

The problem appears to be contributing to the continuing rise in waiting lists, which currently stand at record levels despite heavily funded initiatives to reduce numbers. Overall, at least 530,000 people are on inpatient, outpatient or daycase waiting lists.

Cost of appointment

An outpatient appointment costs an estimated €129 per person, with the cost of a “did not attend” put at €44. This includes the cost of obtaining medical notes from the records library of a hospital, reviewing the consultant’s referral notes and further communications to the GP and patient after a non-appearance.

“In the hospital, appointments are timed and overbooking of clinics is not a regular feature so clinic slots that are not filled are effectively lost opportunities to provide patient care,” says Tony McNamara, chief executive of Cork Hospital University Group.

“Highly trained professional staff have their time wasted because of patients not attending and usually not advising the outpatient department, therefore preventing the appointment slot being given to another patient.”

In 2012, former minister for health James Reilly threatened to charge patients who failed to show up for appointments €20 before they would be seen again. His successor Leo Varadkar promised to introduce group appointments to deal with the problem, but neither initiative was implemented.

Mr McNamara has calculated that non-attendances are costing the health service about €21.5 million nationally, enough to employ an additional 1,000 administrative staff.

Regard for appointments

“What does this say about the regard the population have – or do not have – for outpatient appointments? It is said that if a good doesn’t have a price attached, then it doesn’t have a value; I would contend that this is the case in relation to perhaps one in 10 appointments.”

Mr McNamara says there is an urgent need for an educational initiative to increase awareness of the value of attending for a specialist medical opinion.

“There is also a need for a more informed debate by commentators on the staggering numbers of patients seen in our outpatient departments.

“Rather than focusing solely on waiting list numbers, a more nuanced commentary might be to explain to the public the need to advise departments in advance if they do not intend keeping an appointment so the appointment can be given to somebody else.”