Saturday, March 2, 2024

The Good Doctor’s Blog: “500 no shows in a month at just two Thurrock surgeries.”

The NHS and the “Gimme More” Generation

By Dr Emil Shehedah

Apparently we are not giving enough timely appointments in General Practice. Really?! Here is what most GP’s would say:

1.This morning, we have had 14 appointments in excess of demand.

2.Every month, no fewer than 400 to 500 appointments are not attended in my two practices.

3.Some of the non-attendees have the audacity to book another appointment later that day, thus using up two appointments for one simple problem.

4.When some of these entitled users are asked for an explanation as to their failure to attend, they become rude and aggressive.

5.Some patients consult their GP within hours of developing minor symptoms, such as a headache for which they have not even taken a humble Paracetamol.

6.Some demand an urgent appointment, and we rarely turn patients away. When they attend, GP’s are amazed at people’s perception of “urgent”.

7.Others will attend four times per week for a simple sore throat.

8.We, like most GP’s, are available to patients from 8:30 am to 6:30 pm every working day. On two days a week, we see patients as late as 8pm.What more can any reasonable person expect?!

9. Often patients ask for urgent appointments, for simple problems, and when they are given a same-day appointment, they claim they are too busy. Amazing!

10.The number of times GP’s have to chase patients, for their routine chronic disease management, is beyond measure. These are people who have had a condition for several years and know that they need to have certain checks done annually. The rude reaction GP’s get from some such patients is disheartening. Rudeness and ingratitude aside, every time such people fail to attend, they are preventing another patient from getting an appointment.

11.For eight months, my wife and I gave up our Saturdays, for no additional fee from the NHS, to offer more appointments. All we achieved was more demand from some of the same people, most of whom did not need an appointment. We probably received two thank you’s in the entire period.

12.The aim of the NHS is to empower people to look after themselves. However, GP’s report a greater degree of dependence on medical professional, that is the exact opposite of what the NHS wants to achieve. What we have achieved is a generation who “must” have a GP consultation for simple problems that require no medical input. And when they can not get what they want, rather than what they need, a puerile rude aggressive reaction is not unusual. This is the “Gimme More Generation”.

The NHS will not survive for long, unless patients change their attitudes. The NHS is NOT free. Some people are paying for it. Its resources are limited. The days are coming soon when patients will have to contribute personally towards the cost of their health care. The more demanding we become, the sooner that day will come.

What we need is an effective patient-participation-group, who can help patients see things from the provider point of view, and challenge the public to improve their attitude to this rare resource called appointments.


  1. I agree that the amount of no-shows is horrendous but sometimes it is unavoidable. Are there any statistics taken for genuinely unavoidable no-shows?

    “The rude reaction GP’s get from some such patients is disheartening. ” – While this is true, have you thought about the rudeness of some GPs towards their patients when they turn up for appointments on time? Some GPs can be extremely rude to their patients to the point of showing a disdain for the sick as though they are nothing but an annoyance.

    While your points are extremely valid, please don’t ignore the actions and attitudes of some GPs to their patients when they have done nothing wrong.

    I totally agree with the idea of having effective Patient Participation Groups but it shouldn’t just be to show patients the provider’s point of view, it should be to show the patient’s point of view to the provider too.

    PPGs are, in fact, a legal requirement but how many GPs actually advertise that fact or even have one?


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