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NHS Wales to remove no-show patients from waiting lists

By Mark Mansfield
Jeremy Miles

Chris Haines, ICNN Senedd reporter

Patients who miss two appointments without good cause will be removed from waiting lists for NHS treatment, Wales’ health secretary announced.

Jeremy Miles warned more than 700,000 appointments are missed each year, with 14% of all outpatient appointments lost because people do not turn up or cannot attend.

“That's not right and it's not sustainable,” said the Labour politician. “And it doesn't help us to make sure the public gets faster access to the care they need.

“So, in future, we will provide patients with two offers of dates for an NHS appointment. If those appointments are not kept without a good reason, they will be removed from the list so that their place can be taken by somebody else.

“Every person's circumstance will be considered. Patients who are vulnerable and children will be protected but we want patients to keep their appointments or to cancel in good time so their place can be taken by someone else.”

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‘Part of the solution’

James Evans, the Conservatives’ shadow health secretary, responded: “I tend to agree with that. We need to make sure the public do actually take a bit more responsibility with their appointments within the NHS but I do urge a little bit of caution.

“And I just need to make sure… this policy is not going to unfairly penalise vulnerable people, those who struggle to get transport, especially in Powys, for example, where people have to rely on public transport to get to appointments. It's not always readily available.

Mr Evans cautioned that people who struggle with their mental health sometimes cannot go to appointments, with the minister reiterating that vulnerable people will be protected.

Urging people to do all they can to keep appointments, Mr Miles added: “It is really important that that capacity is available for patients who are able to take up those appointments. We all want to see access to care becoming faster, and so that's an important part of the solution.

“It's a partnership approach between the [Welsh] Government and the NHS on the one hand and the public on the other, and my anecdotal reading of it is that people do understand that that is an important part of the way forward.”

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‘Good progress’

In a Senedd statement about waiting lists on June 3, Mr Miles stressed that reducing long waits is his number one priority as he pointed to some signs of good progress.

“We've seen the waits of more than two years falling by two-thirds,” he said. “At the end of March, long waits fell to… just under 8,400. This is the lowest level since April 2021.

“The size of the overall waiting list had reduced for the fourth month in a row.”

Mr Miles, who was appointed in September, said the health service will commission the private sector to carry out a significant number of treatments.

He recognised the problem is most acute in north Wales and emphasised : “I expect the health board to meet its plans to significantly reduce long waits.”

‘Baseless targets’

Mr Miles told the Senedd: “We will reset and reduce the overall size of the list by March 2026, bringing it back towards pre-pandemic levels.

“It is within our grasp to reduce the size of our waiting list by as much as 200,000 pathways over the next year.”

But Mabon ap Gwynfor, Plaid Cymru’s shadow health secretary, warned Welsh ministers have failed to hit their own targets from 2022 despite moving the goalposts multiple times.

He asked: “What measure of success is seeing over 8,000 people waiting over two years… after promising that no person would be waiting for more than two years by March of 2023?”

Mr ap Gwynfor added: “With finite resources, we must prioritise the right things, rather than introducing a wide range of baseless targets.”

‘Fair funding’

He called for a fair funding settlement for Wales from next week’s UK spending review, saying: “The current system and settlement fail entirely to provide resources in proportion with the needs of Wales: older people, more ill health and greater poverty levels.”

Mr ap Gwynfor welcomed a recent improvement but pointed out that 600,000 people – almost one in five of the population – continues to wait for treatment.

Labour’s Hannah Blythyn welcomed positive progress, with two-year waits down 67% over the past three years and more than 12,000 patients coming off the list.

She said: “We should be honest here that the progress has been made possible thanks to additional investment made possible by two Labour governments working together.”

Rhys ab Owen, an independent, expressed concerns about a shortage of anaesthetists, warning it will ultimately lead to the cancellation of treatments and longer waiting lists.

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40 comments

Mab Meirion

Two cancellations without good cause will see Smiles removed from the Senedd...you are like a bad smell mate...

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Mab Meirion

He should have been gone long ago, still if the disabled can survive another cold, hungry and anxious winter there may be a spring of hope. Not something likely to bother that drop-in center for has-beens...that is if we have not been nuked yet to shut down Clark's North Korea on Thames before it comes to anything...

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Mab Meirion

You're a weird lot down south, the more they kick you the more you stick up for them...

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Mab Meirion

If they have cocked up your appointment twice through their own fallibility surely any sane person would not applaud it... Except on here of course, as I said some of you are not the full shilling down there, are you?

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Mab Meirion

The Senedd workers are logging on...

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Evan Aled Bayton

It is very important not to do this especially in mental health without clearly knowing why. Waiting lists should be dynamic and flexible.

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Adrian

The NHS is still sending letters and faxes: for as long as it's still using prehistoric communication methods it is in no position to handle this sort of thing. My Denplan surgery sends multiple texts and emails to ensure appointments are not missed. I'd have a hard time claiming not to have been aware of the date or time.

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Llyn

Faxes are not sent to patients. I think you'll find there are many many elderly and others who still rely on letters.

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hdavies15

All it takes is for patient to advise clinic/hospital what their comms preferences are and make sure it's on the file. Letters are unreliable especially for short notice appointments. Works for me.

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Adrian

They can still have letters if they prefer, but that's not how the real world handles such things, and hasn't been for quite some time.

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Peter J

I recently had surgery: for every appointment, I was sent an automated letter, but also a text message for me to confirm attendance, and a further message a day or so before to remind of the appointment. That said, the operation was in England, because I’m in North Wales. This doesn’t take a lot of effort to set up tech wise.

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Badger

If you're going to make stuff up why not go with carrier pigeons and smoke signals?

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Adrian

Greetings from the real world! How are things in there?

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Cwhiet

They have no infrastructure to support digital approach, everything have is vulnerable and are just straight intercepted by MitM and third party scammers. They fail to meet basic GDPR needs and zero proprietary security for medical confidentiality. If you use their App or WhatsApp services, you may as well just hand out a piece of paper with all you private details to anyone inc scammers you bump into.

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Paul M

I got chucked off a list I'd been on for four years. I never got a letter. When I phoned up I was told it was my own fault. That a letter was sent. They had my phone number and email address, which made it even more frustrating. Hywel Dda, btw.

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Steffan ap Huw

Also, good luck getting through to them on the phone to inform them the appointment they've made is not feasible. There have to be other channels available, like a chatbot on their website, for example.

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Welshman28

Exactly but you have no where further to take your complaint

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Simondc1711

About time where we the oublic take responsibility for our health and realise that with scarce resources the NHS needs everyone to play their oart. It should mean that patients who genuinely need that appointment and always attend or let the NHS know if they have to cancel receive a quicker service. There are always going to be hard cases where a patient thriugh no fault of their own miss an appointment date, however, this should be factored into the process and should not be a black or white decision but decided on the evidence provided by rhe patient whether they are suffering from a physical or mental condition?

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Bethan

I don't want to be accused of political double-speak but what constitutes 'good cause' according to the Welsh government? It could be argued that most people wouldn't book an appointment without good cause or fail to attend without good cause. Particularly nowadays with waiting lists being so long. I would speculate that if people are failing to show up for appointments there is a reason behind it and it might be worth investigating. I understand that the NHS is under strain but implementing policies that make 'the rules' more and more rigid, unapproachable and unrealistic for patients kind of defeats the purpose of the NHS. This sounds kind of like a ploy to deter people from even asking for appointments just to cut costs. More data is needed before casting judgement on the general public here. For instance, They say it wastes £700,000. Okay. Is that a lot. In governmental coffers context, to me that sounds like pocket change but alright. Lets say it was £7,000,000 or a higher number that might leave a dent. How does that differ from previous years and decades? The public needs to have this information before forming an accurate opinion because, I know people don't like to hear it, but wasted taxpayer money is inevitable and expected in a functioning society. It's the same argument as, 'a few people recieving benefits might be grifters so lets punish everyone'. Waste is normal and taken into account before calculating the overall costs per year. I know people would prefer that not a penny goes unused but, come on. This is the real world. That has never and will never happen. If people aren't able to keep an appointment, it's within their rights to cancel. If they can't go they can't go. Obviously if some people are routinely abusing the system and treating the NHS as if it's some sort of phone app that only affects the business if they reneg on the arrangement then of course, people who honour the service should take priority over them, but I really doubt that's the case with most cases. There are a lot more efficient ways to improve the NHS at this moment in time. This is a cheap and tacky way, and Oh, shocker! It's the public's fault everyone. That darn public are at it again, wreaking havoc. I'm tired of hearing how awful the general public are. The general public aren't in control are they? The general public don't have the power, resources, influence or status to make any kind of change for the better. Their elected do. This is the thanks they get for voting for these genuine money sponges.

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Cwhiet

If they played their part, we might actually know about appointments before they happen and not just get nasty rude non-medical receptionists having a go that you did not attend something you had no knowledge was booked!

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Emma

They send letters while you are on the waiting lists asking you to confirm you still want to be on the waiting list or you will be removed! They just want us off them to get the numbers down. Any means necessary! Shame on them 😕

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Mab Meirion

Is there a death spike on a Sunday, when every patient becomes a mystery due to the ad hoc staffing arrangements...? Speaking as one who witnessed such an untimely death. a two hours I won't forget or forgive...

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Mab Meirion

Bye Bye Smiles, get him out of the ring, their blows are landing and Smiles is precious and must be protected for some reason...

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Badger

It's only fair to let someone else have the spot if they want it enough to not be upset about reconfirming their place.

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Simon

So even more work for us GPs. Everyone of those patients will have to return to their GP for a re-referral and will repeatedly attend for us to try to manage their problems when we already know their is little more we can do. They will also continue to be out of work, reliant on benefits. We know patients want to attend. The problem is waiting lists are too long, communication systems are outdated and unreliable, and appointment booking systems are inflexible and inaccessible.

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Mab Meirion

Nailed it in three but you left out the lying, the deadly incompetence and the silence of the holy order of NHS executives...the untouchables...

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hdavies15

Negative markers are gunning for you today boyo. But keep up the barrage of comments and criticisms, no point quitting just cos some people are too touchy

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In reply to hdavies15

Mab Meirion

You disappeared yesterday pretty sharpish, bridges all day but this rag needs to put its hat on if it wants to be in the band...

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Joseph Elias

There may be trouble ahead. Speaking from experience, I have faced first hand the devastating and detached reality of "missing appointments". However, much of this was through domestic abuse earlier on. Then further issues caused by no fixed abode. This new rule will penalise those in need most and will further destroy and marginalise those who because of systemic failings, already suffer.

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hdavies15

If you are of no fixed abode there's nowhere to send letters to ! Maybe text to mobile is O.K if you have a mobile, otherwise .....?.

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Mab Meirion

Smiles all over...sadism is the thrill of choice in Labour circles, they have taken government into the marriage bed to thrash out the details...

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Howie

Attended a hospital in Aneurin Bevan last evening for a scan, they asked for the letter, I replied not got one I was phoned yesterday morning offering this appointment here today or another hospital on Friday, I would not have got a letter for either in time.. Many of us use the Wales NHS app for our surgery appointments and medicine orders why can't the NHS in Wales use it for hospital appointments as well. There will still be a cohort that require other methods of contact.

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Welshman28

First try sending the letters in plenty of time, failure to attend is cause by appointment letters not being received till after appointment date. We have the worse postal service in Europe . Why is it if you fail to answer a text your taken off waiting list. I’ve been on a waiting for 4 years , I’ve had 3 texts asking do I wish to remain on list, I’ve had 3 calls on my mobile asking me do I still want to be on list. How many people are taken off list if no reply

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Welshman28

Why is it always patients fault when if the numbers are high there MUST be a problem sending letters Hospitals won’t admit failure

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Genette

Two family members have missed hospital appointments to which they were never invited. They only found out because they rang to find out when they would be seen. No letter ever turned up.

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Y Cymro

Where I agree that those who deliberately miss NHS appointments without notifying the hospital first need to be made responsible for their actions. And if this means being taken off the waiting list. So be it. There are so many waiting months if not years for hospital appointments. Playing Devil's advocate. I'll reverse the question. What about appointments and surgery cancelled by the hospital trusts due to lack of beds , available specialists , and so on... Will Health Minister Jeremy Miles responsible for the running of our Welsh NHS face similar actions i.e be forced to resign? If not. It's do as I say not as I do.

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Mab Meirion

Diolch Y Cymro...

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Albert moss

Perhaps they should look into why people are removed from the waiting list without any reason. Or perhaps it’s just to reduce the waiting list to look good.

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Cwhiet

So far I have received one notification about an appointment before the appointment takes place, out of 13. clearly the issue is whoever is organising the letters being sent etc.

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Anne

Letters are sent out, constant reminders via text also patients who have interpreters booked for them failing to attend this is after they've attended the appointm ent it's been agreed with patient via the attending interpreter, therefore no reason to not attending 2 or maybe 3 for the appointment which cost over £200.00 each time. People just don't care. Genuine patients attend, I work for ABUHB one patient didn't attend. Her reason she had the hiccups yes your reading this right, a other excuse it was raining. I therefore agree 2 strikes and your out!!!!

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Replying to hdavies15 Cancel

If you are of no fixed abode there's nowhere to send letters to ! Maybe text to mobile is O.K if you have a mobile, otherwise .....?.

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