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A GP with his patient
A GP with his patient. Photograph: Anthony Devlin/PA
A GP with his patient. Photograph: Anthony Devlin/PA

NHS England makes too much of ‘cost’ of missed GP appointments

This article is more than 5 years old
Letters from Dr Christopher Price, Dr Tim Gent and Helen Keating

NHS England claims that missed GP appointments cost the NHS £216m each year (Money wasted on missed GP slots could fund 2,300 doctors, 2 January).

While it is frustrating for those struggling to get a timely GP appointment to hear that 15m appointments are lost in this way, it is very misleading to attach a monetary value to a missed appointment. It is plain daft to list the things this money could be used for, as it is “sunk costs”. Once a GP surgery is scheduled, it incurs a set of fixed costs – the wages of the GP and other staff, the running of the building etc.

Even if no patients turn up, these costs have been incurred and the money isn’t available for an alternative use.

Bearing in mind that most GP consultations end up with a prescription or a referral, I would argue that each missed appointment probably represents a saving to the NHS. Nor should we be worried that a missed appointment leaves the GP twiddling their thumbs. I always used the time to do paperwork or just get back on schedule, meaning that subsequent patients had a shorter wait.

Using the term “wasted” implies fecklessness on the part of the patient, which is seldom the case. It is more likely that they are struggling to balance family and work demands, have been let down by transport arrangements – or are too ill to attend.

If you want to address waste in the NHS, I would suggest that getting rid of NHS England would be a good starting point.
Dr Christopher Price
Retired GP, Norwich

I understand why the measure of missed GP appointments might be expressed in terms of cost. However, it is ludicrous to draw up a wishlist of how any money saved might be spent. There is no single cause of this problem and ideally all missed appointments should be explained, but don’t be fooled into thinking that the effect is anything other than to allow those who do turn up a little more of our time.
Dr Tim Gent
Norwich

Reading that “one in five patients now has to wait at least 15 days to see a family doctor” makes me realise not only how lucky we are here in south-west Scotland, but also how well organised our practice obviously is: we can ring up at 8am and see a doctor that day – sometimes within an hour and a half. This, too, is in a practice shared between two towns and which is short of doctors. Three cheers for the ones we do have and for the practice staff who organise them!
Helen Keating
Gatehouse of Fleet, Kirkcudbrightshire

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