Patients' failures to keep GP appointments could be costing the NHS up to £185m a year, according to a survey by Doctor Pat ient Partnership and the Institute of Healthcare Management.

On average, 18 appointments per GP and eight appointments per practice nurse are missed every week, the survey of more than 1,000 practices found.

DPP chair Dr Simon Fradd flagged up the need to tackle the number of 'do not attends' in primary care if government targets on speedy access to GPs were to be met .

'In the government's NHS plan the target of GP appointments within 48 hours by 2004 has been set out. Clearly a reduction in the number of missed appointments will have a big impact .'

Rosey Foster, deputy chief executive of the IHM, described the figure as 'unacceptable'.