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Half of Scottish patients missed one or more appointments over three years

Nearly half of patients that took part in a Scottish study on missed appointments in primary care have failed to attend one or more appointments in the last three years.

A study published in The Lancet Public Health looked at the appointment history of 550,083 patients over three years and found that 46% missed one or more appointments in that time, with 19% missing more than two appointments.

Of the 13,623,316 primary care appointments studied over the three-year research period, 12% were not attended - of which 91% were missed by serial DNAs. 

The researchers found that female patients over 90 years old and from a low socioeconomic background are the most likely to miss multiple appointments.

They admitted that appointment allocation - for example, to a practice nurse instead of a GP, or to a particular GP - may have an impact on the likelihood of a patient not attending, but inconsistent recording by practices meant that this could not be analysed.

Practices where patients have to wait between two and three days to book an appointment had the highest DNA rate, compared with practices that offer on-the-day appointments.

To mitigate the number of DNAs, the study said that practices should consider ‘selectively offering on-the-day appointments for patients at high risk of serial non-attendance’.

It said: ‘Practices in more affluent areas seem to be more poorly equipped to accommodate patients who repeatedly miss multiple appointments than practices in more deprived areas and could benefit most from similar adaptations to their existing appointment systems.’

Dr Andrea Williamson, GP and lead author of the study from the University of Glasgow, said the study considers frequently missed appointments as ‘health harming behaviours – complex behaviours that have their roots in experienced adversity’.

She said: ‘From our findings it would suggest that future ways to increase attendance should focus on positive strategies to support a patient’s attendance.’

Lancet Public Health 2017, online 4 Dec