Opinion Former Article

GPs get advice from MDU on dealing with patients who miss appointments

GPs are being given six steps to consider when patients fail to attend appointments, to help improve attendance and avoid medico-legal issues.

Missed appointments are an ongoing problem within the NHS, with Jeremy Hunt revealing in 2015 that they cost the health service almost £1 billion per year, and GP appointments are estimated to contribute £162 million to this figure.

Writing in the latest edition of the Medical Defence Union (MDU) journal, medico-legal adviser Dr Ellie Mein explains the legal position:

“GPs often ask the MDU whether they would be vulnerable to a complaint or claim if a patient suffered harm following a missed appointment. While GPs cannot compel patients to attend appointments, there are steps they can take to show they have made reasonable efforts to engage and help the patient.

“Legal responsibility for missed appointments inevitably depends on the precise circumstances of each individual case. If there is a claim for compensation, the ‘Bolam test’ would apply; the GP would not be negligent if their actions didn't fall below the standard expected of a reasonable GP. If the issue resulted in a GMC referral, then the steps the doctor had taken to speak with the patient and check on their condition would be considered.

“Careful records of correspondence sent to the patient, any discussions with the patient setting out detail of the advice given, and in particular a record of the explanation given to the patient as to why it was important to attend, would help if a problem arises.”

The MDU points out that while it won't be practical to chase every patient who misses appointments, there are six questions GPs can ask if they were worried about a patient repeatedly not attending:

Is the patient receiving correspondence about appointments? Are their contact details current?
Does the patient have any memory issues or health reasons that might prevent them remembering they were due at the practice?
Is there any reason the patient would be reluctant to attend the practice, or leave their house?
Are there practical reasons preventing the patient attending, such as caring for a sick relative or poor mobility?
Do they understand what the appointment is for and why it was important to attend?
Do they realise the implications for their health of not undergoing medical review?

For the first time, the MDU journal also offers doctors the chance to earn CPD. In the lead article, medico-legal adviser Dr Samantha Bell explains doctors' personal and professional responsibilities when responding to patient complaints made online and via social media.

Readers can then take an online assessment to test their understanding of the subject and earn one hour of CPD, accredited by the RCP.

Read the MDU Journal at:  https://mdujournal.themdu.com/


The MDU is a not-for-profit organisation wholly dedicated to our members’ interests. Our team is led and staffed by doctors with real-life experience of the pressures and challenges faced in practice.

We offer our members expert guidance, personal support and robust defence in addressing medico-legal issues, complaints and claims. Our customised services range from legal assistance to indemnity to appropriate CPD.


Dawn Boyall, Laura Baker or Thenuka Mahendrarasa in the MDU’s press office

t:     020 7202 1535/1504/1541
m:   07773 772 816/ 07903 192902
e:    dawn.boyall@themdu.com, laura.baker@themdu.com, thenuka.mahendrarasa@themdu.com
w:   themdu.com

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