When patients fail to attend an appointment, it can be hugely frustrating for a number of reasons. It is also very costly, according to recent NHS England data that suggests up to 15 million general practice appointments are being wasted each year – at an estimated cost to the NHS of £216 million.

In a busy surgery, somewhat ironically a ‘no-show’ can provide some welcome catch-up time. While it would be easy to simply mark the patient as having not attended and move on, careful consideration should be given to the following:

• Has the patient been invited to attend for a specific reason and, if so, does this require further follow-up? For example, the patient may have been asked to come in to discuss important test results, for chronic disease management, or for an important screening test (such as the cervical screening programme).
• If the patient has been invited to attend for a specific reason, was the invitation sent to the correct address?
• Are you aware of any reason why the patient has been unable to attend – for example, have they been admitted to hospital or has the patient passed away?
• Have you a specific concern about the patient’s non-attendance? For example, you may have spoken to the patient and asked them to attend surgery on an urgent basis. If so, it would be prudent to follow this up in an appropriate way.

Similar principles should be followed when your surgery becomes aware that a patient has not attended a hospital appointment.

Safety netting

In the primary care setting, it is not always possible to identify the purpose of the appointment or why the patient did not attend. However, practices should develop procedures to address a patient's non-attendance at both the practice and in secondary care, which could include the provision of a sensitively-worded reminder about the importance of attending appointments.

It is important to remember that the patient may not have been able to attend for reasons beyond their control – non-attendance does not always mean that they no longer need an appointment.