Is It Really That Difficult to Cancel a GP Appointment?

Fundamentally I believe that we as patients must understand our responsibility to respect the free access we have to our GP, practice nurse, midwife or other primary care based professional. We expect their professionalism and access to them in a timely manner - it's not a lot to ask that we should also keep our side of the bargain too.

My GP's surgery, in common with many others, publishes a monthly figure of the numbers of people who missed their appointments. In July alone, that amounted to 191 wasted consultations.

The surgery is located in a fairly rural part of the home counties, covering a large catchment area and serving a population with a relatively high socioeconomic status. Or to put it more simply, I would imagine that the vast majority of patients have access to a phone, and quite possibly more than one. The surgery offer an opt-in service to be texted in advance of your appointment to remind you about it. For cancellations, they have a dedicated number to text to cancel an appointment if you can't get through on what is, admittedly, often a very busy switchboard number.

All of which begs the question, is it really so difficult to cancel a GP appointment that 191 patients couldn't do that in just one month? Ever since I became a patient at the surgery, the figure for missed appointments has always been over 100, but as it edges ever closer to 200, I find myself increasingly questioning the attitudes and values of my fellow patients.

My fear is that these statistics, which granted are very small scale compared to the whole of the NHS, demonstrate an underlying thoughtlessness that many people have in relation to accessing primary care. I genuinely wonder if the fact that it's still currently free to see your GP ensures that some people simply don't respect the expertise that they have access to.

There has been a lot of talk about levying a charge to see a GP in the future, and whilst I firmly believe in the ideals of a free-at-the-point-of-use NHS, those that don't respect the service are putting the rest of us in danger of being charged for it. There are few more powerful arguments for levying a fee to see a GP than the one that suggests patients might just respect the GP's time and the services provided more if they were having to pay for them. Moreover, even if it didn't change patient behaviour, it would generate additional revenue.

Most people who access paid-for services, be that dentistry or other professional practitioners or complimentary therapists, are clearly warned that failure to attend an appointment without cancelling it is likely to incur a charge. How effective that is in practice inevitably varies across the country, but from my personal experiences, when I've accessed paid-for services I have never seen statistics in the waiting room that tell me nearly 200 people didn't show up for their appointments in any given month.

The situation with wasted GP appointments infuriates me even more when you consider just how overstretched primary care services are, and how long patients who genuinely want and need an appointment sometimes have to wait. Maybe missed appointments give GP's a short interval to complete some other record keeping/paperwork related task and in reality that time isn't 'wasted' as such, but from the perspective of other patients it's consultation time that's gone and will never be regained.

In fairness to the 191 people behind those missed appointments in July, I'm sure some had genuine and very valid reasons why they never managed to cancel their appointment. A family or work crisis, a loved one suddenly taken ill, an unexpected transport failure, or an illness or condition that meant that they unintentionally forgot to go to their appointment. These scenarios will of course always occur and are entirely understandable, but I think there is more behind that 191 figure than personal misfortune or health conditions that cause forgetfulness.

Fundamentally I believe that we as patients must understand our responsibility to respect the free access we have to our GP, practice nurse, midwife or other primary care based professional. We expect their professionalism and access to them in a timely manner - it's not a lot to ask that we should also keep our side of the bargain too.

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