Non-attendance at general practices and outpatient clinics

“Non-attendance at NHS outpatient clinics and at general practices is more common in deprived populations. It results from the organisation of these services, which currently puts the needs of staff before those of patients. Discuss.” Proposing this debate at your next management away day should enliven proceedings. What evidence exists for the various parts of the statement? The national figure of 12% for non-attendance at outpatient clinics in the United Kingdom hides large variations between specialties and between regions. Studies report figures that range from 5% to 34%. 1 2 Much less research has been done on non-attendance in general practices, though figures of 3% and 6.5% have been reported. The first figure comes from an unpublished doctor-patient partnership survey in 1998 and an unpublished survey (by WH) of 500 non-attenders in Exeter. The higher figure is from a study of 221 000 appointments in practices in Sheffield.3 Different methods have been used to assess deprivation, such as extrapolation from postcode data, information from interviews or postal questionnaires, and validated indices of deprivation.4– …

[1]  H Killaspy,et al.  Prospective controlled study of psychiatric out-patient non-attendance. Characteristics and outcome. , 2000, The British journal of psychiatry : the journal of mental science.

[2]  P. Hodgkin,et al.  Defaulters in general practice: who are they and what can be done about them? , 2000, Family practice.

[3]  R. Lancashire,et al.  Factors associated with clinic non‐attendance in adults with Type 1 diabetes mellitus , 1998, Diabetic medicine : a journal of the British Diabetic Association.

[4]  G. Harris,et al.  Risk appraisal and management of violent behavior. , 1997, Psychiatric services.

[5]  M. Lloyd,et al.  Non-attendance at outpatient clinics: is it related to the referral process? , 1993, Family practice.

[6]  D. Sharp,et al.  Patient, hospital, and general practitioner characteristics associated with non-attendance: a cohort study. , 2002, The British journal of general practice : the journal of the Royal College of General Practitioners.

[7]  A. Gatrad A completed audit to reduce hospital outpatients non-attendance rates , 2000, Archives of disease in childhood.

[8]  M. Gilhooly,et al.  Non-attendance at periodontal clinics: forgetting and administrative failure. , 1994, Journal of dentistry.

[9]  P. Koegel,et al.  The prevalence of specific psychiatric disorders among homeless individuals in the inner city of Los Angeles. , 1988, Archives of general psychiatry.

[10]  J. Bonta,et al.  The prediction of criminal and violent recidivism among mentally disordered offenders: a meta-analysis. , 1998, Psychological bulletin.

[11]  D. Sharp,et al.  Effect on hospital attendance rates of giving patients a copy of their referral letter: randomised controlled trial , 1999, BMJ.

[12]  E. Torrey Jails and prisons--America's new mental hospitals. , 1995, American journal of public health.

[13]  M. Cosgrove,et al.  Defaulters in general practice: reasons for default and patterns of attendance. , 1990, The British journal of general practice : the journal of the Royal College of General Practitioners.

[14]  R. Murray,et al.  Reducing violence in severe mental illness: randomised controlled trial of intensive case management compared with standard care , 2001, BMJ : British Medical Journal.