Madam,

Your 7 June editions recorded that Betsi Cadwaladr patients failed to turn up for seven per cent of booked outpatient appointments. The very definition of a patient is someone who in some way is unwell and all over the world a percentage of such unwell people are unable to make a planned medical appointment on the day.

Potentially such non-attendance wastes resources and Betsi Cadwaladr cannot afford to leave any clinical resource under-employed. The recently published Betsi Cadwaladr three-year plan records that the demand for services from Betsi Cadwaladr exceeds the resource capacity that the board possesses by 13,500 patient pathways per year and that this is likely to continue. That is 13,500 patient each year facing unnecessary long waits and suffering. So when Betsi Cadwaladr leaves a resource idle, because some patients feel too unwell to keep an appointment, or patient transport fails to turn up, it seriously impacts someone else’s health. But what is the Betsi Cadwaladr board doing about it?

Many healthcare organisations world-wide operate a model of overbooking their clinics, as do other resource-limited operations such as airlines. When patients fail to appear at clinic, other patients are present to receive the clinician’s attention and close to 100 per cent utilisation is achieved. Other healthcare organisations operate the ‘urgent supplement’ model. Primary care clinicians are permitted to late book a small number of urgent cases to a clinic who will be seen when a gap arises from a booked patient’s no-show. Such patients are happy to sit in clinic for an hour or two waiting for a no-show gap because their treatment will be accelerated by the ‘urgent supplement’ scheme as a result.

Perhaps you could encourage Betsi Cadwaladr to explain the model they use to ensure that the resources booked for no-show, unwell patients are utilised by others waiting and that the unused part of our NHS resource in north Wales is minimised. Surely, the Betsi Cadwaladr board should do more than just send a text or two and moan about unwell people being unable to turn up.

Yours etc,

Tom Brooks, Borth-y-Gest, Porthmadog.

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