THE doctor won’t see you, or the patient who wishes they had your appointment, because you never turned up nor did you cancel it.

Everyone knows how frustrating it can be, sitting on the phone for ages, trying desperately to get through to your GP so that you can get an appointment. Not only do I hear about the issues with access to primary care services from patients all the time, I too have felt frustrated, as a service user, when trying to book an appointment for myself or a family member.

Sometimes getting a GP appointment can be the most stressful part of the patient journey when it should be the easiest.

One can only assume then that when you manage to secure an appointment, honouring and turning up for it, would seem like the next obvious thing to do? However research continues to show us that this is not the case as we face over 13 million missed GP appointments, otherwise known as “did not attend” (DNAs), each year.

In a bid to manage the high volume of DNAs, GP practices have, over the years, reviewed access to services and tried to improve rates of patient attendance by implementing measures such as phone and text reminders. It was found that the highest DNA rates were amongst those who had pre-booked their GP appointments which made it more likely for patients to forget. Many practices have therefore adopted an “on the day” booking system to try and combat the rising patient demand but also lessen the impact that DNAs cause on the wider system. Sadly these measures do not appear to be improving or resolving the situation as DNA rates continue to rise.

Just this week, during my morning surgery, five out of 15 patients – who had only called up and booked their appointment that very morning – failed to turn up. No reasons were given and two of them were sadly repeat offenders who have previously received warnings.

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There are numerous reasons for why patients could miss an appointment and it is important to remain compassionate to the varying needs and possible reasons behind a DNA.

The first thing that goes through the mind of every clinician when a patient fails to turn up is, “I hope they’re ok.” A no-show certainly makes my mind wander as I, by default, predict the worst until I can get hold of them by phone and gain reassurance.

Once I have confirmed this however, I do make it a point to educate them on the practice policy and how to cancel an appointment in future if they cannot attend.

We all know how much pressure the NHS is currently under. There are many reasons for this. The primary care service needs more money invested in it, needs more resources but most importantly needs more GPs and allied healthcare professionals to be working in it to meet the rising patient demands. Whilst this is being addressed by the Scottish government, we are far from achieving that longterm vision. In the meantime, we need to come up with solutions where everyone understands they have an important role to play in the successful running of the NHS.

We are fortunate to be living longer as a society however what comes with this is that people are living with chronic health problems and have more complex healthcare needs.

The time of healthcare professionals is therefore precious and limited and must not be taken for granted.

When the phone lines go live every morning, its bedlam behind the scenes as staff frantically try to deal with all the requests. Appointments get snapped up within minutes, often leaving many to try again later or the next day.

Some suggest we should “fine” and punish patients who DNA. It’s not as easy as that. Life happens to all, someone may miss an appointment due to their health problem, may have deteriorated at home or may have simply forgotten – which as a one-off can be forgiveable right?

We need to increase awareness that missed appointments are a real problem and costing the health service millions of pounds every year, money we simply cannot afford to throw away.

Currently practices issue warnings for repeat offenders with most having a policy of three strikes and you’re off the GP list.

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This leaves the patient to find an alternative practice. Is it worth the hassle?

GPs face a lot of criticism but I assure you that it is not all rosy behind those closed doors. It is incredibly stressful as we try to do our best for all. We don’t want to be disciplining people over simple etiquette because frankly put, we have more important jobs to be doing. All we ask is for you to review if you really need your appointment.

To turn up on time for your appointment. To phone up and cancel if you no longer need your appointment.

This isn’t to ease our lives – a cup of tea is welcome if we get a spare 10-minute gap – but this fundamentally is to ensure that everyone who needs seen, gets seen and doesn’t end up in A&E or, worse still, come to more serious harm.