There were 513,000 ‘no shows’ to hospital outpatient appointments in Ireland last year, according to the HSE.

Figures released to The Hard Shoulder show that 14% of all appointments were missed in 2023, or 10,000 per week.

The problem was most severe at the Mater Hospital in Dublin where 41,825 appointments were missed last year, followed by St. James's Hospital (39,744) and Beaumont Hospital (38,718).

IMO Consultant Committee Chair Matthew Sadlier told the show cancellations are a big problem for the HSE.

“It’s about one in seven or 14% of all appointments,” he said.

“That doesn’t sound as dramatic as 500,000 cancellations but it’s a significant number.

“This also has to be taken in the context that there are 3.5m appointments every year.

“As someone who works in the service, it does lead to wasted resources and it’s something we do need to tackle, and have needed to tackle for a very long time.”

The entrance to the Mater Hospital in Dublin. Image: Vitalli / Alamy

Dr Sadlier said how appointments are recorded is often the issue.

“Too much of our health service still relies on paper,” he said.

“When someone is finished in their outpatient clinic, you have to write their name down in a diary to book their appointment.

“With the best staff in the world, you will still have cases where when you’re about to write it down, you’ll get a phone call or someone asks you a question and it doesn’t get it into the diary.

“We used to take two days a year and shut down outpatient services altogether to go through charts and paper records to see who missed the service.

“If you had an electronic-based appointments system, you could do it in two clicks of a button.”

Text reminders

Dr Sadlier proposed text reminders as a potential fix to reduce cancellations.

“If you go to your dentist or your hairdressers, most people will get a text reminder that you have an appointment in three days,” he said.

“It lets people know, and it gives them the opportunity to say if they can’t turn up.

“If you could say that 14% wouldn’t show up every day, that would be fine, but that’s not the case – it’s too unpredictable.”

File photo of the entrance to St James's Hospital.

The HSE's former Director of Digital Transformation, Professor Martin Curley said the problem is “quite big” in Ireland, in comparison to other countries.

“If you look at the UK, it’s far more digitised, but our ‘did not attend’ numbers are twice that of the UK," he said.

“Every time someone misses an appointment, it impacts the whole service.

“If you look at our annual waiting lists, there are around 500,000 or 600,000 on it.”

Not working

Prof Curley said current fixes aren’t working.

“Last year, there was a waiting list action plan where they spent 450m in achieving an improvement - and the reduction was only 2.7%,” he said.

“That’s a lot of money to get a very small improvement.

“There are so many reports, but even just simple text reminder systems can reduce 'did not attend' by anywhere from 30% to 80%.

“If we could switch to digital, this could make a big dent.”

The total number of hospital appointments missed in Ireland in 2022 was 485,371.

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Main image: The Mater Hospital in Dublin 7. Image: KarlMPhotography / Alamy Stock Photo