Patients missing appointments – maybe they never needed them?

To hear Julia Manning, Chief Executive, 2020health, on BBC Northampton discussing personal health records, please click here. The interview starts at 1h 17 minutes.

To hear Gail Beer, Consultant Director, 2020health, on BBC Kent discussing the issue of 5.5 million missed appointments every year, please click here. The interview starts at 1h 11 minutes.

Julia Manning for the Daily Mail, 29th August 2012

If someone doesn’t turn up for an appointment there are only a few possible reasons: they died; they forgot; transport failure or they didn’t need the appointment in the first place. The figures for the number of people not turning up for NHS appointments were revealed over the bank holiday weekend – one in ten people don’t attend an appointment totaling 5.5m missed appointments in the last year. This includes appointments people have made for themselves.

BBC local radio also covered yesterday the forthcoming 2020health report on how few people are being given electronic access to their health records (one in 100), despite the evidence showing that patients who take up the service usually have better health.

The common theme here is that NHS remains far too paternalistic, with doctors making many decisions without involving the patient and still regarding intimate details about an individual’s life history (i.e. the patient’s notes) as belonging to the state. Legally notes do still belong to the NHS, but despite the fact we have had the right to see our records for a couple of decades, many professionals still view us as passive recipients of care instead of active participants who should be involved in planning and management. This includes whether we really want an appointment, or just a quick call for reassurance or leaving it to us to decide. I recently sat by a doctor’s desk in a large London teaching hospital as he viewed his PC. He hadn’t looked up when I walked into the room; he’d spoken to either the notes or the screen, and it was only when I said “and I’d like a copy of my test results” that he looked at me. “Why would you want those?” he asked abruptly as if talking to an unreasonable child.

Personal electronic health records will go a long way to enabling us to take more responsibility for our healthcare. More information leads to greater understanding and awareness and can lead to improved health. The proliferation of health apps show that there is a real appetite for information and self-care. The government should be falling over itself to encourage electronic access and approving apps as this will reduce the burden on the NHS and go some way to reducing the 40% (according to GPs) of unnecessary appointments, easing the difficulties experienced by some patients who have found it harder to get an appointment because of their local surgery reducing their opening hours. And if we really are going to have a system that people value and includes rights, responsibilities and redress, then we should be charged the cost of the appointment if we don’t show up (easily done with an electronic system) which will help us decide whether we needed the appointment in the first place!

About Julia Manning

Julia is a social pioneer, writer and campaigner. She studied visual science at City University and became a member of the College of Optometrists in 1991, later specialising in visual impairment and diabetes. During her career in optometry, she lectured at City University, was a visiting clinician at the Royal Free Hospital and worked with Primary Care Trusts. She ran a domiciliary practice across south London and was a Director of the UK Institute of Optometry. Julia formed 20/20Health in 2006. Becoming an expert in digital health solutions, she led on the NHS–USA Veterans’ Health Digital Health Exchange Programme and was co-founder of the Health Tech and You Awards with Axa PPP and the Design Museum. Her research interests are now in harnessing digital to improve personal health, and she is a PhD candidate in Human Computer Interaction (HCI) at UCL. She is also dedicated to creating a sustainable Whole School Wellbeing Community model for schools that builds relationships, discovers assets and develops life skills. She is a member of the Royal Society of Medicine’s Digital Health Council. Julia has shared 2020health's research widely in the media (BBC News, ITV, Channel 5 News, BBC 1′s The Big Questions & Victoria Derbyshire, BBC Radio 4 Today, PM and Woman's Hour, LBC) and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week.
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