A new Irish study has highlighted the negative impact of patients who make appointments to see their GP, but then fail to show up.

Patients who do not show for their appointments can deny others the opportunity to make an appointment and can affect the profitability of GP practices.

Currently in the UK, these patients - referred to as ‘did not attends' (DNAs) - cost the NHS around €162 million per year, however there is little or no data on this topic for Ireland, so two Dublin-based doctors decided to investigate further.

They audited a busy medical clinic in Glasthule in Co Dublin over the course of a week to assess the typical DNA rate. Patients who actually cancelled their appointments were excluded, as were patients whose appointments were changed to house calls.

The practice had a constant presence of five to six doctors and three to four nursing staff. Over the course of the week, there was a non-attendance rate of 5.6% among the doctors and 7.4% among the nurses.

While some of these were put down to ‘patient circumstances and plain forgetfulness', the 5.6% figure among GPs, when extrapolated over a year, represented a total of 41 missed days - ‘the equivalent of a full-time doctor missing for more than a month'.

"While GPs may use spare time generated by missed appointments to fulfill other tasks, the overall impact felt by other inconvenienced patients - who are denied another appointment option or possibly an appointment at all - and the income of the practice as a whole clearly outweighs any benefit," the doctors said.

A day-by-day breakdown of the figures revealed that the highest rate of DNAs occurred on a Friday, although Monday and Tuesday were close behind. The lowest DNA rates occurred on Wednesday and Thursday.

Two in three of the DNAs were supposed to attend morning appointments and over half had made their appointments for that day or the next working day.

Meanwhile, 84% of DNAs had medical cards.

"The fact that the vast majority of the DNAs were medical card holders is no surprise given the obvious lack of financial motivation," the doctors said.

The study noted that the highest number of DNAs for this practice was among people in their 20s. They suggested that as many of the missed appointments were in the morning, ‘perhaps scheduling afternoon appointments for these patients would cut down on missed appointments'.

The doctors also noted that a large percentage of DNAs related to appointments made on a Friday for the following Monday or Tuesday.

"These patients' ailments may have improved and they forgot or did not bother to cancel their appointments. Issuing scheduled reminders for appointments booked on Friday for the following week would seem to be of potential benefit, either via text on Sunday, or even via an automated phone line," they said.

The doctors acknowledged that GPs may not wish to raise this topic with patients as it may damage the doctor-patient relationship ‘and ultimately cost the practice business'.

"Similarly, any idea of imposing a monetary fine for missed appointments would be very difficult to implement and could also result in lost custom," they noted.

They added that making it easier to cancel appointments could help, for example, allowing people to cancel via text or email, as well as direct phone calls.

"While some of these suggestions may challenge available resources, they could at least be focused on repeat offenders," the doctors added.

Their research is published in Forum, the Journal of the Irish College of General Practitioners.