Around one in five hospital outpatient appointments were unattended in England last year, new data has revealed.
The figure is up on a decade ago, when the number was closer to one in six.
Of the 21% of appointments that were unattended in 2016/17, roughly a third were due to patients not turning up.
(PA Graphics)
Cancellations by hospitals and patients each accounted for another third.
By contrast, in 2006/07 almost half of all unattended appointments were due to people not turning up.
The figures, from NHS Digital, also show that the total number of outpatient appointments has nearly doubled since 2006-07, rising from 63.2 million appointments to 118.6 million in 2016-17.
The data also showed that London had the lowest attendance rate of any region in England last year (77.3%), while the North of England had the highest (80.9%).
Older patients, between the ages of 60 and 79, accounted for 31.5% of all attended appointments.
Women were also shown to account for a greater proportion of those who attended appointments (57.8%), compared with men (42.2%).
(John Stillwell/PA)
Diagnostic imaging, such as x-rays and ultrasounds, recorded the greatest ratio of patients keeping their appointments versus those who did not show up (one did-not-show for every 100 appointments).
Perinatal psychiatry (psychiatric health related to pregnancy) saw the highest ratio of patients not turning up, with two no-shows for every five attendances.
Trauma and orthopaedics accounted for the largest proportion of total kept appointments of any specialist treatment at 8.3%.