Exeter NHS missed appointments cost local trusts millions since 2019

New research has revealed that missed NHS appointments have cost trusts in the South West of England tens of millions of pounds over the past five years, with Exeter-area trusts among the hardest hit.

New Freedom of Information data, obtained by business communication specialist Esendex, shows that Devon Partnership NHS Trust recorded 119,219 missed appointments between 2019 and 2024, costing approximately £19 million. Over the same period, University Hospitals Plymouth NHS Trust had 237,364 missed appointments, with a total cost of almost £38 million.

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For 2024 alone, Royal Devon and Exeter NHS Foundation Trust reported 72,872 missed appointments, while Torbay and South Devon NHS Foundation Trust recorded 23,108 no-shows. Each missed appointment is estimated to cost around £160, underlining the financial impact on local healthcare services.

Across the South West, the total number of missed appointments in 2024 reached 37,515, costing local trusts around £6 million. Nationally, Esendex’s analysis suggests more than 11.8 million appointments are missed each year, potentially costing the NHS £1.9 billion annually.

Speaking on any initiatives the trust is currently undertaking to reduce the number of missed appointments, Royal Devon and Exeter Trust confirmed: “The Trust has a programme of work ongoing to look at ways to reduce DNAs. We are working with specialties to target areas that have higher than average DNA rates, analysing if there are any themes or process issues that can be reviewed to support patients attending their appointments. Targeted work with our diabetes department has seen the DNA rate reduce from 12 per cent to 8 per cent.”

“There are many reasons that patients do not attend appointments and we are also developing a programme in Epic, our electronic patient record system, to predict patients that might not attend and see if we can offer telephone appointments in place of a face-to-face appointment or adding in additional reminders for these patients.” 

“We are working with colleagues across the South West to understand what practices work for them and if we can share any lessons, and we are exploring alternative timescales for the appointment reminder service (currently reminders on days seven and two, but studies show reminders on days 14 and four are more effective).”

Chris Gorman, Head of Commercial Transformation at Esendex, said: “The volume of missed appointments across the NHS is incredibly frustrating, not least for the staff working on the front line who face the administrative and financial burden of no-shows. Each missed appointment has its own cause, from transport difficulties to being unable to take time off work or arrange care at the scheduled time.”

Phil Luke, Interim Chief Operating Officer at Royal Devon and Exeter Trust, said: “While missed appointments do have an impact on NHS financially, they also affect the time our patients are waiting to receive the care they need, and we have a number of initiatives in place at the Royal Devon to look at reducing these missed appointments.”

 “We would also like to remind our patients that signing up for MY CARE is a great way to keep track of their appointments. It allows patients to confirm if they are attending their appointment or request a cancellation – which enables us to offer the appointment slot to another patient and helps reduce our waiting times.”

Patients in Exeter also recognise the challenge. Local resident, Helen Carter, who recently had to rearrange a hospital appointment, said: “I understand why people sometimes can’t make it, but it’s upsetting knowing someone else could have used that slot. Better reminders would help everyone.” 

Another resident, Tom Bailey, added: “It’s not just about money - it affects the quality of care. When appointments are missed, waiting times for others increase and staff get overwhelmed. There should be more flexible ways to confirm or reschedule appointments.” 

Chris added that many trusts still rely on letters to confirm appointments, which can be lost or overlooked. “With people leading increasingly busy lives, traditional communication methods often fail to capture attention. Trusts may need to explore SMS, RCS, or WhatsApp notifications to reduce missed appointments and improve patient engagement.”