This site is intended for health professionals only


Half of GPs want to fine patients who don’t attend appointments



Exclusive Just over half of GPs think patients should be fined if they don’t turn up to appointments, a Pulse survey has revealed.

The survey of 821 respondents, open only to GPs, found that 51% backed the fines.

A further 12% said they were not sure, and just over a third (37%) said they disagreed fines should be levied for did not attends (DNAs).

The response comes as GP appointments have become harder to come by, with the average waiting time now around two weeks.

Health secretary Jeremy Hunt said two years ago that he did not have a problem ‘in principle’ in charging patients for missing appointments.

A north London GP who backed fines told Pulse that the DNAs at his practice were enough to give one GP a week off every month.

Another London GP thought a £10 charge would be reasonable for patients who fail to attend.

A GP in north-west Surrey said: ‘When some services appear “free” some patients do not always appreciate the true costs to provide that service.’

Others suggest removing repeat DNA patients from their list or charging patients a refundable deposit.

A GP partner in west Kent told Pulse patients had to take responsibility and stressed: ‘We cannot continue to pretend that this is not a problem.’

One doctor suggested that it should be up to the NHS to collect the money. Another said patients with dementia should be exempt.

One GP in Glasgow, who opposed fines, said there were other ways of cutting DNAs, without hitting people’s pockets.

His practice sends text reminders to patients and also offers a large percentage of on-day appointments.

‘By doing so we have cut DNAs by over 900 appointments a year,’ they said.

Some GPs thought it would not be worth the time spent on administration and appeals and time is better spent all triaging patients.

Some GPs also said they had plenty of work to do to fill the time they would have spent seeing the no-shows.

A locum in Devon said: ‘Most who DNA are in a terrible life situation and it would make their lives worse and they would not have the money to pay anyway.

‘The admin charges of collecting the money would far outweigh any income generated from it.’

Another locum from west Lincolnshire said: ‘A DNA is a GPs’ saviour.’

The BMA said it ‘has consistently opposed charges for patients as such a system who require an expensive, cumbersome bureaucracy to collect and issue fines’.

A spokesperson said: ’Those who may be most likely to miss appointments, particularly vulnerable patients, may also be the people who would be exempt from fines and fining them is not the way to address some none attendance issues.’

Mr Hunt also told the told the RCGP conference last month that GPs felt they were on a ‘hamster wheel’ of 10 minute appointments. 

Meanwhile, a survey of 40 practices by Wiltshire CCG found patients missed 37.5 days of care at every practice through did not attends.

They amounted to 281 missed appointments between July and September last year.

Should patients be fined for not attending GP appointments?

Yes – 51%

No – 37%

Don’t know – 12%

The survey was launched on 10 October 2017, collating responses using the SurveyMonkey tool. The 25 questions asked covered a wide range of GP topics, to avoid selection bias on one issue. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a Ninja Coffee Bar as an incentive to complete the survey. A total of 821 GPs answered this question.