First insight into which patients repeatedly miss GP appointments
Many people are regularly missing GP appointments, according to the largest ever analysis of NHS patients who fail to attend. The study revealed that socio-economic deprivation is the most important indicator of why patients will miss multiple appointments.
The study, which is published today in The Lancet Public Health, was led by researchers at the University of Glasgow in collaboration with colleagues from the Universities of Lancaster and Aberdeen. The study examined the characteristics of patients who do not keep appointments with their doctors, sometimes on dozens of occasions.
This is the largest UK survey on missed appointments carried out to date. The researchers tracked the appointment histories of over 500,000 patients in Scotland for 3 years from 2013-2016 using NHS data provided on condition of patient and practice anonymity.
It is also the first ever survey of patients who miss multiple GP appointments and revealed that:
• Nearly 20% of patients missed more than two appointments over a 3 year period
• 46% of patients missed one or more appointments per year
Dr Andrea Williamson, lead author of the study from the University of Glasgow, said: “These first results about the profiles of patients who struggle to attend GP appointments support clinical intelligence that patients who serially miss, have high levels of social and health vulnerability.
“Our work in this study is based on the theory that serial missed appointments are ‘health harming behaviours’ – complex behaviours that have their roots in experienced adversity. From our findings it would suggest that future ways to increase attendance should focus on positive strategies to support patient’s attendance."
The research revealed that patients most likely to miss multiple appointments are more likely to be aged 16 to 30 years-old or aged over 90 years-old.
Co-author of the study Dr David Ellis of Lancaster University said: “Although we found that age was a factor, the most important patient-level factor to predict the likelihood of serially missing GP appointments remains high levels of socioeconomic deprivation.”
Patients were also more likely to miss multiple appointments if they were registered in GP practices which either offered appointments in 2-3 days following a booking request or were located in affluent urban areas.
Dr Ross McQueenie from the University of Glasgow added: “Our results suggest that socioeconomically deprived patients living in more affluent areas might have particularly high levels of unmet health need in primary care settings.”
The paper, “Demographic and practice factors predicting repeated non-attendance in primary care: a national retrospective cohort analysis” is published in The Lancet Public Health. The study was funded by the Scottish Government Chief Scientist Office and Data Sharing and Linkage Service of the Scottish Government.
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First published: 4 December 2017