This study, led by Dr Andrea Williamson in Glasgow, uses the records of over 800,000 people in Scotland to help us understand the phenomenon of repeated missed appointments in General Practice. GP records were linked to other administrative datasets containing data on mortality, hospital admissions etc.

Two important publications have already had a significant influence on policy and practice. Ellis et al (Demographic and practice factors predicting repeated non-attendance in primary care: a national retrospective cohort analysis. Lancet Public Health 2017;2(12):e551-e59. doi: 10.1016/S2468-2667(17)30217-7) showed that repeated missed appointments are significantly more common among people living in deprived areas and among both young adults and older people, but also that practice-related factors were important.

McQueenie et al (Morbidity, mortality and missed appointments in healthcare: a national retrospective data linkage study. BMC medicine 2019;17(1):2-2. doi: 10.1186/s12916-018-1234-0) showed that people who miss more than two appointments per year over three years have a very annual high mortality rate (about 5%) independently of the number of long-term conditions they have.

The association of missing many appointments with mortality is particularly marked among people without physical long-term conditions: these patients generally die at a very young age, and from non-natural causes. Work is ongoing to investigate the association of missed appointments with ADHD, Adverse Childhood Experiences, hospital service use and unmet health needs.