Patient 'no-shows' a waste, say doctors

Thousands of operations and specialist appointments are cancelled every year because patients fail to show up, district health board figures show.

Senior doctors say patients who cancel on the day or simply fail to arrive are a huge drain on the cash-short public system.

But they have stopped short of calling for fines or sending errant patients to the back of waiting lists, which would add expensive layers of bureaucracy and put lives at risk.

Instead, health boards are looking at innovative ways of ensuring patients turn up, such as allowing them to book their own appointments.

Association of Salaried Medical Specialists executive director Ian Powell said last-minute cancellations were "extremely wasteful" while thousands of patients were on waiting lists.

"It's usually impossible to schedule another patient for that day because of all the preparation involved and the need to give people notice.

"Every patient who does not turn up for their appointment, for whatever reason, not only jeopardises their own health but the health of other patients who miss out. It's frustrating for specialists and surgeons."

In 2006, under pressure from the Government to reduce waiting times to below six months, Waitemata District Health Board began dropping from the elective surgery waiting list those patients who did not turn up for their first specialist appointments.

But Mr Powell said he did not support "punishing" errant patients by removing them from waiting lists or fining them.

Trying to fine patients for no-shows would put another administrative burden on hospitals.

"The patient who fails to show up for an appointment is most likely to avoid payment for anything, especially a fine, so it would be a waste of money."

Figures provided to The Dominion Post under the Official Information Act show big regional variations of "did not attend" rates.

Capital and Coast has successfully slashed the number from more than 1000 in 2003-04 to 263 in the last financial year.

About 20,000 procedures are done under anaesthetic at Wellington and Kenepuru hospitals each year.

Paediatric surgeon Brendon Bowkett said "did not attends" used to be a problem in his department but several measures, including pre-assessment clinics, meant patient cancellations were rare now.

"Going back five years, our operating time was cut by 20 per cent so there has been a huge management focus on increasing efficiency to make the most of the time we have."

But the percentage of Wellington outpatients who fail to turn up to specialist appointments has remained constant at 9 per cent, which is the national average.

In the year to March, there were almost 22,000 missed appointments at Capital and Coast.

Between March and November 2008, just 19 operations were cancelled at Hutt Hospital because of "did not attends".