NHS appointments are a mess

There has been much discussion recently about fining people for missing NHS appointments and the consensus seems to be that people have no excuse for missing them and it is only fair that they should pay a fine when they do so. 

My experience suggests that it is quite easy to miss them, because the appointments system is a mess, and my situation is much simpler than many people's.

I am documenting my views here so that I can easily share them as and when required, starting with the hospital's Patient Advise Liaison Service.

My appointments cycle

I have one underlying condition that is being managed by one hospital. I continue to see my GP for other things like the recent flu and Covid booster jabs.

This condition means that I need to see one consultant every three months and another every six weeks with the second visit followed by a treatment session the following day. I also have two scans every other treatment cycle, i.e. once every twelve weeks, which are done at a separate site.

That means that at any one time I have five future appointments booked.

Different appointment systems

The big problem is that there is no consistency in how these are managed:

• For the two consultants appointments I get paper letters and they also appear in the NHS app, which means that I get automated reminders by text
• For the two scans I get paper letters but nothing else
• For the treatment sessions I have an appointment card (!) which gets updated by hand each visit.

The only place all these appointments are consolidated is on my fridge where I store all the letters and appointment card in date order. 

I also put them all in my online calendar manually which is prone to error (more on that later).

Other issues

There are several other niggles in the systems that while are not significant in themselves they all add to the friction in the system and increase the chances that errors will be made. One such niggle has already caused me to get one appointment wrong, luckily I arrived a day early so no really damage was done.

Where electronic communications are used, e.g. NHS app, this just points to a message that is in the form of a PDF file that contains an image of the letter, i.e. it is not possible to simply cut and paste the appointment details in to a personal calendar. 

Many apps that I use, e.g. MeetUp, have an "Add to Calendar" function and NHS app should be able to do this too.

There are inconsistencies in the naming of locations within the hospital, e.g. letters refer to "Oncology & Haematology Outpatients” whereas the signage in the hospital says Haematology & Oncology Outpatients (HOOP)", and the two letters for the scans 

The letters for the scans give the data (dd/mm/yy) but not the day of the week, which is how most people refer to dates most of the time, e.g. it says "31 October 2024" rather then "Thursday 31 October 2024".

The two letters for the scans have slightly different descriptions for the same address. They also use different sized fonts. which may be an attempt to keep all of the main information on the front page.

I sometimes get automated reminders to my landline! I did not know that the hospital even had this number much less intended to use it. I am not sure which appointments these are for as I never listen to the whole message once I know who it is from.

Summary

Three things should happen:

1. The NHS app should be used for all appointments
2.  The app this should link to personal online calendars
3. Appointment letters to patients should be reviewed for consistency and clarity.