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Should patients be told of the cost of missed GPs' appointments?

The health secretary, Jeremy Hunt, has suggested that he would have no objection to charging patients who miss appointments with their GP, and that in future patients will be informed how much they have cost the NHS if an appointment is missed. Dr Kate Owen GP and Principal Clinical Teaching Fellow at Warwick Medical School examines the issues involved.

At first glance this may appear a fair enough approach, but we need to examine who is missing appointments and why before coming up with potential solutions.

The groups of people who are most likely to miss GP appointments are young people, people with mental health issues and those from lower socio-economic groups: people who we know have poorer access to health. Charging or even chastising people within these groups may have the effect of disengaging them even further from the healthcare that they need, negating the attempts that GPs are making to build up positive relationships with them. People may have very genuine reasons for missing appointments including ill health and personal difficulties, informing them that they have cost the NHS money may add to their upset.

Patients often forget appointments when they have been made several weeks in advance, or try to cancel but are unable to get through to the practice on the phone. Simple techniques such as asking patients to write down the appointment, or repeat it back to the receptionist have been shown to increase attendance. New technologies can also help; practices are increasingly adopting on-line booking services allowing patients to cancel 24 hours a day and many practices use text message reminders.

There is no suggestion how patients will be informed how much their missed appointment has cost the NHS- but there will be a cost associated with carrying this out. This money may be better invested in widening use of technologies to help patients remember appointments and better able to cancel them.

Notes to Editors

Contact Nicola Jones, Interim Communications Manager, University of Warwick,, 02476 150868, 07824 540863.


Nicola Jones

Interim Communications Manager

University of Warwick

tel: +44 (0)2476 150868 or

+44 (0)7824 540863.