A Registrar Survival Guide - dealing with latecomers

Your surgery is running fairly smoothly, albeit you are 20 minutes behind. It appears that two patients have not attended, allowing you to catch up. A message appears from reception informing you that the two 'non-attenders' have arrived, apologised and wish to be seen. You have six patients left in your surgery, three of whom have arrived.

This scenario is common and practitioners may find that this disrupts the surgery and can potentially have a negative impact on subsequent consultations.

GPs will differ in how they approach this situation. It is difficult to turn a patient away when you are unsure what the presenting problem is. This runs the risk of compromising patient safety.

Refusing to see a patient could also lead to a breakdown in the doctor-patient relationship, which in turn could jeopardise the outcome of a consultation.

If, however, a patient is repeatedly late and the reception staff have noticed this trend, it would be fair to inform the practice manager so that they can take appropriate action, which may include a written warning. Consider the following:

How much time do you have?

  • Where are you in your current surgery? If you are half way through and patients are waiting, this may make seeing a late patient very difficult unless they are willing to wait until the end. If you are at the end of the surgery, you may be willing to still see the patient.
  • Are you already running late? If so, the potential additional stress of a late patient could compromise subsequent consultations.
  • Do you have any gaps?
Essentials checklist
  • An unrushed approach.
  • A sense of calm.
  • An ability to assess the situation before deciding when you will see the patient.
  • Good organisation skills.


Avoid rushing the consultation

If you agree to see a late patient, ensure you do not rush either this or subsequent consultations. Make sure you are happy to see them and are not feeling pressurised by the additional workload.

Age of the patient

A young or elderly patient may have a more justified reason for a late attendance, for example mobility problems, so make allowances for this, particularly if you feel it may be difficult for them to reattend.

Stay calm

If you are experiencing a stressful surgery, remember to contain your frustration and stay calm. As doctors, we are professionals trained to deal with not only patient emotion, but also our own. If you appear frustrated or stressed, this is likely to be transferred to the patient and can lead to a negative outcome.

  • Dr Singh is a GP in Northumberland

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