Do missed GP appointments cost the NHS £160m per year?

"Missed [GP] appointments cost the NHS £160 million a year." Daily Mail, 18 June 2014

Health Secretary Jeremy Hunt's remarks yesterday on the future direction of the NHS caught the eye of several newspapers this morning. While the Express focused on migrants' access to the health system, the Mail led with a claim that patients won't be charged to visit their doctor.

Some, including the British Medical Association and Royal College of Nursing, have suggested introducing a fee to cut down on the number of missed appointments, which the paper says costs the NHS £160m per year.

While this figure has been widely quoted, the only published source for it is seemingly a survey of doctors conducted in 2004. There is no official data on missed GP appointments, and more up-to-date research might be needed if this claim is to be substantiated.

Lots of claims, little published evidence

The Mail is in good company in claiming that missed appointments cost the NHS £160m: NHS England itself used the figure earlier this year, and it has featured in numerous media reports.

We've been in touch with NHS England, the Health and Social Care Information Centre and NHS Choices to try to trace the source of this claim, and none have yet been able to direct us to it.

As the government has said, there is no official data on the number of GP appointments missed, nor on the potential cost to the NHS.

However it is striking that the same figure appeared in reports as far back as a decade ago. These referred to a survey of 700 GP surgeries conducted by Developing Patient Partnership and the Institute of Healthcare Management, which found that 3% (9 million) of doctors appointments in the last year were missed by patients, which at an estimated £18 loss each time accounted for a cost of £162m to the NHS.

We don't know if this is the source of the figure quoted by the Mail and others, but if so there are some reasons to be cautious. The survey is now 10 years old, and it was reported at the time that the proportion of appointments missed was falling.

We also don't know if the 700 surgeries surveyed was a representative or self-selecting sample (i.e. whether surgeries that experienced a particular problem with missed appointments were more likely to respond). We've contacted the Institute of Healthcare Management about the research and will update when we know more.

So while we need more information before we can draw any conclusions about the accuracy of this claim, it is worrying that it can be so widely used without a clear and up-to-date source being provided.