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Missed appointments 'waste of taxpayers' money'

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Patients failing to attend NHS dental appointments in England could be denying significant numbers of other people the chance to access care, according to a survey by the British Dental Association (BDA).

The survey suggests that committed NHS dentists in England each lose the equivalent of almost two weeks a year because patients fail to turn up for appointments.

The BDA believes that the research highlights a problem of a significant scale and that the option to charge a fee for missed appointments, abolished as part of the widely criticised 2006 reforms to dentistry, should be reinstated.

If the experiences of the dentists surveyed by the BDA reflect those of predominantly NHS dental practices across England, the research would indicate more than 3.5 million dental appointments were missed last year.

Responses to the BDA research suggest that the problem is more prevalent among new patients than those who have been visiting a practice for many years.

They also suggest that the problem has become more acute since dental practices' ability to charge patients for missed appointments was abolished in 2006.

John Milne, chair of the BDA's general dental practice committee, says: 'Sometimes there are genuine reasons why it's just not possible for a patient to keep an appointment with their dentist and everybody understands that, but the results of this research suggest that the scale of this problem is significant.

'Dental surgeries use letters, telephone calls and even text messages to remind patients of forthcoming appointments, so it's really disappointing to see that so many people appear prepared to deny others access to care by failing to show up.

'This not only wastes dentists' time, but also taxpayers' money. With many people still failing to secure the dental appointments they want, and the public purse under pressure, that's simply unacceptable. This problem needs to be tackled and the BDA believes that the Government should consider reintroducing a fee for patients who miss appointments to deter them from doing so.”

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Heres a thought. Charge NHS dental patients a registration fee which is a deposit refundable on leaving the practice. DNA's are deducted from the deposit. When the deposit is down to zero, re-registration is required to make an appointment. The practice benefits from a low cost loan which keeps costs lower for all patients.

Posted by edwardmk 19/1/11 at 21:18

Not a bad idea edwarkmk.
However ni my experience the patients who fail to attend repeatedly (with no good reason) are the ones that you don't want to have in your practice. I rather stop seeing them after 2 FTA's as it is now as it is now than wasting more precious clinical time on them. (The suggested FTA fees will never be high enough to cover your running costs anyways)

Posted by Frasse 19/1/11 at 22:15

Hmm! Fines can work both ways. How about fining practices for not seeing patients on time. The claim that it costs taxpayers X amount of pounds when patients fail to keep appointments is one regularly wheeled out in NHS hospitals on missed O/P appointments. This is best described as hypothetical accounting since it costs nothing at all and clinical time and facilities are simply transferred to those that do attend. Which usually means other patients are seen closer to their appointed time.

I don't know how EdwardMK squares charging NHS dentistry patients a deposit for a service free at the point of delivery. And will patients receive interest on their deposits?

Posted by Leviathan 21/1/11 at 13:08

Well, Leviathan, an alternative solution is adopted by us: put all the patients onto Denplan, and effectively they have paid for their appointment anyway, if they don't turn up we just have a cuppa. Where did you get the notion of 'free at the point of delivery'? This has not been true of NHS primary dental services for most adults since circa 1950.

Posted by docholliday 21/1/11 at 15:23

Leviathan,
With all do respect for your opinion, you don't have a clue about how Dental practices operate. Clinical time and fixed costs can not "simply be transferred to those who attend" because if I have given an appointment at 10.00 am to a patient for 1 hr for root canal treatment and he/she doesn't show up (the 11.00 am patient can not be "beamed to take his/her place" (by Captain Kirk and Scotty of Space Ship Eenterprise) That 1 hr clinical time is wasted. The Practice manager, the receptionist and nurse/s have to be paid even if the practice does not generate an income for that 1 hr. this is the concept of fixed running cost for you information. The bank expects to be paid interest on their loans to us and etc. etc. The reason Dentists sometimes run late and ask the next patient to wait is almost always that there is an emergeny patient booked in, a complication in the ongoing treatment has arisen and ... We don't just sit there doing nothing and deliberately making the next patient wait! It would be against our own interest in running a practice. Ultimatekly NHS patients will pay the price. That is absolutely fine with me. Good luck to them finding another practice who will be willing to see them!

Posted by Frasse 21/1/11 at 18:17

Sorry! With all due respect!

Posted by Frasse 21/1/11 at 18:58

Leviathan,
I wonder what you'd expect to happen if dental practices were fined for not seeing patients on time? In overbooked NHS clinics, one might argue there are no extra accounting costs, but the cost in stress to clinical staff and frustration to NHS patients kept waiting is another matter. I agree the patient possibly waiting for an hour is now waiting for less time if a few folk don't turn up, but under your suggestion, that clinic would be fined for almost every patient they had booked in. In an overbooking model, since everyone is seen late unless one or two patients fail, almost everyone is seen late. Would you fine for being an hour late? thirty minutes late or ten minutes late? Most NHS dental practices are underfunded, so fining them for running late would not really help their situation. As Frasse previously observed, you could also imagine increased reluctance to help emergency patients in distress if you knew you would be fined for running late. In the well run practices that generally see their patients on time and are not over-booked, failed appointments can and do quickly escalate into a major cost if not managed.
Regarding interest charges, under my original proposal, these would not be paid, as there would be too much admin. I'm sure that the registered patients would not begrudge the lost interest on their deposits (at todays pitiful rates, or even at higher rates in the future ) if it helped them to retain or secure access to a good NHS dental clinic.
As to NHS dentistry being free at the point of delivery, for the majority it certainly hasn't been free since I qualified in 1975. As to the true hidden expense of 'free' NHS dentistry, that is a whole other subject.

Posted by edwardmk 21/1/11 at 23:50