NHS Dental Appointments, Cancellations, Failed Appointments and Patient Registration Policy
Practice: [Practice Name]
Policy Owner: Practice Manager
Approved By: Practice Principal
Effective Date: 8 September 2026
Review Date: 8 September 2027
Version: 1.0
Purpose
The purpose of this policy is to ensure that NHS dental appointments are managed fairly, consistently and efficiently.
The practice recognises that patients may occasionally need to cancel or rearrange appointments. However, missed appointments and short-notice cancellations can prevent other patients from accessing dental care and can result in unused clinical time.
This policy sets out the practice’s procedures for:
- Appointment bookings.
- Cancellations.
- Short-notice cancellations.
- Failed-to-attend (FTA) appointments.
- Repeated missed appointments.
- Patients who have not attended the practice for an extended period.
- Deregistration where appropriate.
- Rebooking following missed appointments.
Scope
This policy applies to all NHS patients registered with the practice and all staff involved in appointment management.
It applies to:
- Routine dental appointments.
- Dental examinations.
- Hygienist appointments where applicable.
- Treatment appointments.
- Emergency appointments.
- Specialist or referral appointments arranged by the practice.
Appointment Bookings
Patients are expected to attend appointments at the date and time arranged.
Reminders are sent as a gesture of good will. Patients are ultimately responsible for any bookings they have made not the responsibility of the practice.
When booking an appointment, staff should ensure that the patient is aware of:
- The date and time of the appointment.
- The type of appointment.
- The expected duration where appropriate.
- The practice’s cancellation procedure.
- The importance of providing as much notice as possible if they cannot attend.
Patients should be encouraged to contact the practice as soon as they know they are unable to attend we require 48 hours’ notice prior, if a weekend please email the practice.
Cancellation of Appointments
Patients who are unable to attend an appointment should contact the practice as soon as possible.
Where possible, patients should provide at least 48 hours’ notice of cancellation.
The practice understands that emergencies and unforeseen circumstances can occur. These will be considered on an individual basis.
Where adequate notice is provided, the appointment may be rearranged subject to availability.
Short-Notice Cancellations
A short-notice cancellation is where a patient cancels an appointment with less than the notice requested by the practice.
Short-notice cancellations will be recorded on the patient’s appointment history.
Where short-notice cancellations become frequent, the Practice Manager may contact the patient to discuss the importance of providing adequate notice and the potential impact on their ongoing care.
The practice will consider individual circumstances and will not treat genuine emergencies in the same way as repeated avoidable cancellations.
Failed-to-Attend Appointments
A Failed to Attend (FTA) appointment occurs where:
- The patient does not attend their appointment.
- The patient arrives too late for the appointment to be provided safely or appropriately.
- The patient fails to contact the practice to cancel or rearrange the appointment.
An FTA should be recorded accurately on the patient’s record.
Staff should not make assumptions about why a patient failed to attend.
Where appropriate, the patient should be contacted following the missed appointment.
Repeated Failed Appointments
The practice recognises that patients may have genuine reasons for missing appointments.
However, repeated FTAs can significantly affect the availability of NHS dental appointments and prevent other patients from accessing care.
Two missed appointments
Where a patient has two recorded missed appointments or on FTA and one short notice cancellation, the matter should be referred to the Practice Manager.
The Practice Manager will review the patient’s attendance history and consider:
- The number and timing of missed appointments.
- Whether the patient has contacted the practice.
- Any known circumstances affecting attendance.
- Whether there may be additional support or reasonable adjustments that could assist the patient.
- The patient’s ongoing dental needs.
Following review, the practice may decide that it is no longer appropriate or practical to continue offering routine appointments to the patient.
Where the practice decides to end the patient’s registration, this must be managed in accordance with the applicable NHS dental contractual requirements and the practice’s procedures for ending the patient-practice relationship.
Patients should not be automatically removed from the practice solely by a receptionist after a third missed appointment.
The decision should be authorised by the Practice Manager or appropriate clinician/practice lead.
Patients Who Have Not Attended for Two Years
The practice will periodically review its patient records.
Where a patient has not attended the practice for two years or their NHS place lapse, the practice may review whether the patient should remain registered with the practice.
A patient who has not attended for two years will not necessarily be automatically removed without appropriate review.
Where appropriate, the practice may proceed with deregistration in accordance with NHS requirements.
Patients With Outstanding Treatment
Before deregistration is considered, the patient’s record should be reviewed to establish whether there is:
- Ongoing treatment.
- Treatment that has been commenced but not completed.
- A clinically significant outstanding issue.
- An urgent dental need.
- A referral awaiting completion.
- Any other reason why ending the patient-practice relationship may be inappropriate at that time.
Clinical considerations must be considered before a decision is made.
Vulnerable Patients and Reasonable Adjustments
The practice will consider whether a patient’s circumstances have contributed to missed or cancelled appointments.
Where appropriate, staff should consider whether the patient may require additional support or a reasonable adjustment to help them access care.
Examples may include:
- Additional appointment reminders.
- Alternative methods of communication.
- Additional time to understand appointment arrangements.
- Carer involvement where appropriate and authorised.
- Other reasonable adjustments identified following discussion with the patient.
Patients should not be disadvantaged because of a disability or other protected characteristic.
Children and Dependants
Where a child or dependant repeatedly fails to attend appointments, the practice should consider the circumstances carefully before taking action.
Where appropriate, concerns should be escalated to the Practice Manager and, where clinically or safeguarding appropriate, the relevant clinician.
The practice’s safeguarding procedures must be followed where there are concerns regarding neglect, vulnerability or access to necessary dental care.
Emergency Care
This policy does not prevent a patient from seeking appropriate emergency dental care.
Where a former patient contacts the practice with an urgent dental problem, staff should provide appropriate information about how they can access emergency dental care in accordance with current NHS arrangements.
Staff should not refuse to provide information about emergency care simply because a patient’s previous registration has ended.
Communication With Patients
Staff should remain professional and respectful when discussing cancellations, FTAs or deregistration.
Suggested wording following a missed appointment:
“We noticed that you were unable to attend your recent dental appointment. We understand that circumstances can sometimes prevent patients from attending. Please contact the practice as soon as possible if you are unable to attend an appointment in future, as missed appointments can prevent other patients from receiving dental care.”
Where there have been repeated missed appointments:
“Our records show that you have missed two appointments without attending or providing sufficient notice. We appreciate that circumstances can sometimes make it difficult to attend. However, repeated missed appointments affect our ability to offer appointments to other NHS patients. Your attendance history will therefore be reviewed by the Practice Manager in accordance with our appointment and registration policy.”
Record Keeping
All cancellations, short-notice cancellations and FTAs must be recorded accurately.
Records should include, where appropriate:
- Date of appointment.
- Appointment type.
- Whether the patient cancelled or failed to attend.
- Date and time the patient contacted the practice.
- Reason provided by the patient, where relevant.
- Contact attempts made by the practice.
- Any correspondence sent.
- Any management decision.
- Date and reason for deregistration where applicable.
Records must be maintained in accordance with the practice’s record-management and data-protection procedures.
Staff Responsibilities
Reception Staff
Reception staff are responsible for:
- Recording cancellations and FTAs accurately.
- Informing patients of the practice’s cancellation procedure.
- Offering available appointments where appropriate.
- Escalating repeated missed appointments to the Practice Manager.
- Not independently deregistering patients unless specifically authorised under the practice procedure.
Practice Manager
The Practice Manager is responsible for:
- Monitoring appointment utilisation and FTA rates.
- Reviewing repeated FTAs.
- Reviewing patients who have not attended for extended periods.
- Ensuring decisions regarding deregistration are appropriately authorised.
- Ensuring staff follow current NHS contractual requirements.
- Monitoring complaints or concerns arising from the policy.
Clinicians
Clinicians should:
- Consider the patient’s clinical circumstances when deregistration is being considered.
- Identify patients who may require additional support.
- Escalate safeguarding or clinical concerns appropriately.
Monitoring and Audit
The practice should periodically monitor:
- Number of cancellations.
- Short-notice cancellations.
- Failed-to-attend appointments.
- Repeat FTAs.
- Patients deregistered following repeated non-attendance.
- Patients who have not attended for extended periods.
- Complaints relating to appointment management.
Findings should be reviewed by the Practice Manager and used to identify opportunities for improvement.
Policy Statement
The practice aims to manage appointments fairly and consistently while recognising that patients can experience circumstances that prevent attendance.
The practice will take a proportionate and individualised approach to repeated non-attendance.
Two missed appointments may trigger a formal review and may result in the patient-practice relationship being ended where appropriate and permitted under the applicable NHS requirements.
Patients who have not attended the practice for two years or more may also be reviewed for loss of NHS place, subject to the applicable NHS contractual requirements and appropriate consideration of their individual circumstances.
Review
This policy will be reviewed annually or sooner if:
- NHS dental contractual requirements change.
- NHS England guidance changes.
- There is a significant complaint or incident relating to appointment management.
- Audit findings identify a need for amendment.
- The practice changes its appointment-management procedures.