Toll on Herefordshire NHS of people who don't show up

The number of people not turning up for booked appointments is so high it means patients are having to wait up to two weeks longer than they need to.

It’s also costing the county’s health service around £1.4m a year – enough to pay for 24 extra GPs.

While waiting times at hospitals have hit the headlines in recent weeks, GP practices are seeing exactly the same sort of record-breaking demand. And 'no shows' are significantly adding to the problem.

NHS Digital data shows that last year an estimated 46,793 appointments were missed without enough notice to invite other patients in the Herefordshire Clinical Commissioning Group area – an average of 128 per day.

Dr Lauren Parry, medical director of the Taurus group of 20 GP practices in Herefordshire

Each missed appointment costs the NHS £30. This includes appointments with nurses, therapists and other practice staff, as well as doctors.

Ironically, a system offering appointments out of hours to suit patients and help manage the pressures has a far worse no-show ratio than normal appointments.

But at evening and weekend sessions at hubs in Hereford, Ross-on-Wye and Leominster the no-show rate is approaching one in eight.

All these no-shows are happening despite text message reminders to patients which allow them to cancel by reply.

It all adds up to the equivalent of a GP, over the course of a week, having no one to see for most of a morning.

One busy Herefordshire practice said that if everyone turned up as booked, they could reduce the average waiting time by a fortnight.

Dr Lauren Parry, medical director of the Taurus group of 20 GP practices in the county, says waiting time cuts would vary between practices, but that ‘Did Not Attends’ are a major issue.

“The whole system is under tremendous pressure and a GPs' time is precious. The number of people needing to be seen is the highest it has ever been.”

She believes a key issue is to get people to understand the impact that they have if they do not cancel in advance and simply don’t turn up.

She said sometimes no-shows are because people did not think through transport issues, don’t know how to cancel a booking easily, and sometimes make ‘just in case’ bookings and then get better and forget about them.

There can also be mental health issues.

At one Herefordshire practice last year they had 1847 non-attendances – 806 with a GP, 589 with nurses, and 343 with health care assistants.

“If all the booked appointments were attended, we would be able to offer appointments approximately two weeks sooner for a GP.”

Nationally 15 million appointments are missed each year, costing the NHS more than £200m. That would pay for 2,325 full time GPs.