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One in 10 patients missed more than two GP appointments in three years

Patients who miss GP appointments are more likely to be from lower socio-economic backgrounds and facing considerable financial pressure, a new study has found.

The report, published in the Lancet, analysed over half a million patients and more than 13 million visits to Scottish primary care.

It found that 19% of patients missed more than two appointments over a three year period, and discovered that men, patients aged 16-30 or over 90 years old, and people of a lower socio-economic status were “significantly more likely to miss multiple appointments.”

On the other hand, urban practices based in more affluent areas with waiting times of a few days were also likely to have patients who repeatedly missed appointments.

Responding to the study, Dr. Richard Vautrey, BMA GP committee chair, explained that GPs work harder than ever to deliver more appointments with increasing patient demand, tighter budgets and widespread staff shortages across the UK.

He went on to say that whilst missed appointments waste valuable time and resources, efforts must be made to understand the reasons for non-attendance.

Dr Vautrey continued: “As the Lancet Public Health report demonstrates, those from lower socio-economic backgrounds are more likely to miss appointments and many of these patients are often under pressure financially or in other parts of their lives, factors that often contribute to their nonattendance.

“It is important that the government and NHS works with GPs to find positive ways to encourage appropriate use of GP services and through education campaigns re-enforces the importance of attending booked appointments, as well as the negative impact missing appointments have on other patients.

“This must be targeted on those groups who are more likely to miss a consultation with their GP.”

Professor Helen Stokes-Lampard, chair of the Royal College of GPs (RCGP) said that this study supports the college’s objection to fining patients who miss appointments as “this could disproportionally impact on the most vulnerable in society.”

She went on to say that whilst the college understands that it is frustrating and wasteful when appointments are missed, it can be “a warning sign that something significant is wrong with the patient and follow-up action is needed – and it may not always be a physical problem but sometimes a psychological or social issue.”

Stokes-Lampard added: “It is interesting, but perhaps not surprising, that the research found that frequently missing appointments correlates with a delay in them getting an appointment.”

She acknowledged that whilst practices try to offer timely and convenient appointments, increasing pressures are making this more and more difficult.

“GP practices across the country are already implementing some successful schemes to reduce missed appointments, from text messaging reminders to better patient education and awareness posters detailing the unintended consequences of a patient not attending.

"But ultimately, we need NHS England's GP Forward View – promising £2.4bn extra a year for general practice and 5,000 more GPs – to be delivered in full and as a matter of urgency, and we need equivalent promises made and delivered in Scotland, Wales and Northern Ireland, so that we can deliver the care our patients need, whatever their circumstances, and wherever in the country they live,” she concluded.

Top image: Paul Swansen

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