New research shows that almost 6.5 million appointments with practice nurses are missed every year.
And the study suggests that practices are beginning to reach the end of their tether about the waste of resources, with 72% of GP surgeries in favour of striking off patients who are regular offenders.
The Developing Patient Partnerships (DPP) report reveals there is also support among the public (65%) and practices (68%) for charging people up to £10 for not keeping their appointments.
DPP chairman Dr David Wrigley said: "In our view striking patients off really is the last resort - but what is clear from this is the level of frustration felt by GP practices and clearly the public don't look too kindly on people missing appointments either.
"It's by no means a 'them and us' situation. DPP has fiercely campaigned over the years to raise awareness of the impact of missed appointments and it looks like the public now realise that it's them who bear the brunt.
"Most practices agree that missed appointments increase waiting times for other patients."
However, Dr Wrigley did acknowledge that practices are not completely blameless, and that they can do more to address the issue themselves.
He said: "The survey results do show that 54% of the public believe that difficulty getting through on the telephone to cancel appointments is also a cause of missed appointments, a fact which is worth practices bearing in mind."
"The number of missed appointments can be tackled by reminding the patients by phone calls, two days perior to the appointments. I think the cost of phone calls will not be higher than the GPs or nurses time. Just an idea, Why not give a try" - Name and address supplied
"The numbers of missed and cancelled appointments with GPs has generally declined but not so those with the Practice Nurse. Patients don't appear to think that our role as Practice Nurse is equally as important" - Name and address supplied