LONDON, England: Recent reports have highlighted the growing number of National Health Service (NHS) dental appointments being missed without cancellation. While patient non-attendance is a familiar problem in dentistry, it is especially consequential in the context of England’s deeply entrenched crisis in NHS dentistry. Dentists warn that missed NHS appointments are adding to the operational and financial pressures on practices already struggling with high demand and limited capacity.
As reported by the BBC, dental professionals have expressed concern over the rising number of patients who fail to attend scheduled NHS appointments. According to Dr Joe Hendron, vice-chair of the British Dental Association’s (BDA’s) General Dental Practice Committee, around one in seven NHS patients missed appointments at his practice over the past year, costing an estimated £56,000 (€64,800*). The financial impact is clearly considerable. NHS dental contracts require practices to meet activity targets, and empty appointment slots make it more difficult to do so.
One factor cited by the profession in relation to non-attendance is the change introduced with the NHS dental contract in April 2006. Before that contract, dentists could charge NHS patients who failed to attend. Dr Hendron told the BBC that his practice’s rate of missed appointments had been below 5% before the change, but rose to about 15% in the first year after the ability to charge was removed. The BDA noted that the NHS contract in England continues to prohibit charging patients for missed appointments.
The issue of non-attendance is particularly frustrating given the ongoing shortage of NHS dental provision in many parts of England. Recent BDA analysis estimates unmet need at around 14 million adults—more than one in four of England’s adult population. Repeated no-shows undermine efforts to improve access for patients who are struggling to secure appointments, particularly in areas where NHS dental services are already limited.
The issue also intersects with wider government efforts to improve access to NHS dentistry in England. These have included the commissioning of additional urgent appointments and the later broadening of their scope. Also, since April, high-street NHS dental contractors have been required to provide a minimum number of urgent or unscheduled appointments. This may place further demand on practices in a system where unused NHS capacity may have operational and financial consequences.
The problem has ignited debate over what NHS dental practices can do to manage non-attendance. The BDA provides guidance to practices on this issue. For example, it states that a single failure to attend is not grounds for removal from a patient list, but that repeated non-attendance may be taken into account when a practice assesses whether it can continue to offer appointments to that patient safely and effectively, provided that it follows a consistent, fair and transparent procedure.
The April 2026 changes to the NHS dental contract in England partly acknowledge the cost of unused capacity. According to the BDA, mandated unscheduled courses of treatment will attract a £15 payment even if the patient fails to attend or the appointment is not filled. For dentists, the unresolved issue is whether NHS dental reform will provide clear and workable mechanisms for reducing avoidable no-shows and managing repeated non-attendance without creating unfair barriers for vulnerable patients.
Editorial note:
* Calculated on the OANDA platform for 25 May 2026.
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