The challenge caused by missed appointments was discussed a few days on Today on Radio 4 when a GP with a national role explained how contacting GP practices to explain that the appointment was no longer required was a great deal simpler than contacting the practice in the first place to book the appointment. She was very articulate and no doubt if most patients heard her explanation at the time they were unable to make an appointment, the number of appointments that are missed without any communication would drop considerably. However the problem is that booking appointments with GPs is very difficult for most people and if they feel they will need to go through the same hoops to cancel the appointment they may give up. I regularly get text messages from my GP but in order to respond to them, they explain that I have to ring the practice at 8am one morning. Not only are the phone lines very busy then, but for many people 8am is when they are travelling or already at work. Of course if it was easier to make appointments whilst people may be more inclined to cancel the ones they couldn’t attend, the overall numbers would also no doubt expand substantially so perhaps GPs are not inspired to do so, but something needs to change in addition to the actions of the people who were due to attend 5% of appointments!