Missed GP appointments cost the NHS up to £650million last year - but ministers have ruled out fining patients who fail to show up. 

At a time when millions struggle to get a GP appointment, the figures highlight the growing strain on NHS services. 

More than 16.2million appointments were missed in the 12 months to March, with each unused slot costing around £40.

The total annual bill is equivalent to the salaries of around 2,500 newly qualified nurses.

In October alone, around two million missed appointments cost an estimated £80.1million, highlighting the scale of the issue facing the health service.

Across England, London recorded the highest proportion of missed appointments at 5.69 per cent, followed by the North West (5.26 per cent) and the Midlands (4.79 per cent).

Former health secretary Wes Streeting had previously ruled out fining patients, describing the idea as a 'slippery slope'.

His successor, James Murray, has, according to The Sun, indicated there are also no plans to introduce penalties for those who fail to attend appointments.

However, polling suggests there is significant public support for tougher action.

A survey of 5,000 voters found that around two–thirds backed fines for missed GP and hospital appointments, with support highest among Reform UK and Conservative voters at 71 per cent. Even among Green voters, 64 per cent supported the idea.

Fred De Fossard, Director of Strategy at the Prosperity Institute, said: 'Although the public are clear that they want to see the NHS remain free at the point of use, it is clear that the British people are fed up with the health service they pay for being abused.'

The issue comes as pressure on GP services continues to grow.

Professor Victoria Tzortiou Brown, chairman of the Royal College of GPs, said there are around 2,258 patients per GP, with far fewer fully qualified, full–time equivalent doctors per patient than a decade ago.

Describing the situation as 'unsustainable', she said: 'General practice is the front door of the health service and all patients should be able to see their GP when they need to.

'GPs are working harder than ever, with over one million appointments delivered every day across England - nearly half on the same day they are booked.

'But too many patients are still waiting too long for appointments or are anxious they won't be able to get the care they need when they need it.'

A Department of Health and Social Care spokesman urged patients to cancel appointments they no longer need.

They told The Sun: 'If patients can't make a GP appointment, it's important they let their surgery know so it can be offered to someone else.

'Patients can also use the NHS App to turn on reminders, making it easier to cancel or rearrange appointments.'

The government has pledged to improve access to GPs through a new contract backed by £485million, which includes a requirement for patients with urgent needs to be offered a same–day appointment.

A further £300million is being ring–fenced to help surgeries recruit additional doctors or extend working hours.

Ministers say the measures are aimed at easing pressure on services and ensuring more patients can be seen quickly.