Which patients miss booked appointments with their general practice and why? A systematic review

Problem

Missed GP appointments have substantial time and cost implications for the NHS, with an estimated 15 million appointments being missed annually. The high volume of missed appointments potentially exacerbates health inequalities of some patient groups, reduces access to general practice appointments, and decreases finite GP capacity. The aim of this review is to examine which patient groups are more likely to miss appointments, and to explore the reasons that patients miss appointments.

Approach

Medline, Premedline, Embase, PsychInfo, Web of Science, Scopus, Cochrane reviews and CENTRAL were searched. Terms relating to General Practice and missed appointments were included in the searches. We included all studies published since 2003 which considered missed appointments using any study design. Titles, abstracts and full texts of results were screened, and relevant data was extracted from included studies. Quality assessment was conducted on included studies, using the Mixed Methods Appraisal Tool. A narrative synthesis will be conducted on included studies.

Findings

Preliminary results indicate that 40 studies fit eligibility criteria to be included in the review, which is ongoing. The review aims to identify patients who miss booked appointments in general practice. Using demographic information about patients who miss appointments we will discuss who books the missed appointments, who the appointments were booked with and reasons why patients missed these appointments. This data will be used to further understand which patients miss booked appointments and why.

Consequences

Understanding missed appointments and the reasons patients miss appointments will help identify patient groups that are more likely to miss appointments and use this information to target initiatives to reduce missed appointments, and shape services to suit these groups. Reducing the number of missed appointments will help to reduce the cost and burden on general practices and the work will help identify any patterns of health inequity within the NHS. This will further help to identify and make plans to rectify unmet need.