Patients who fail to turn up to doctors' appointments are costing the NHS more than £162m a year, according to a report published yesterday.

Patients who fail to turn up to doctors' appointments are costing the NHS more than £162m a year, according to a report published yesterday.

Almost nine million GP sessions and four million practice nurse appointments are missed a year, the study by the Institute of Healthcare Management (IHM) found.

People between the ages of 16 and 34 were most likely to miss a doctor's appointment without cancelling it.

The IHM, with the Developing Patient Partnership (DPP) group, has launched a campaign urging people to "Keep It Or Cancel It" in an attempt to reduce the number of missed GP sessions.

The survey of GP practices also found that two thirds of family doctors were in favour of charging patients who failed to attend booked appointments.

Dr Terry John, of the DPP, said: "Many GP practices are doing all they can to improve access for patients but still a high volume of appointments are being missed. These forgotten millions of missed appointments lead to unavoidable inefficiencies in GP services. It is up to patients to help."

Seven out of 10 GPs said that missed appointments increased the waiting times for those people who needed to see a doctor. Two thirds of practices said that missed appointments were causing them problems.

However, the annual campaign by the DPP does appear to be having some effect. There were 3.5 million fewer missed appointments last year compared with the year before, according to the report.

Rosey Foster, acting chief executive of the Institute of Healthcare Management, said: "The overall reduction of missed GP appointments is to be welcomed and shows that working together, patients and GP staff can make a difference in reducing the forgotten millions. There are, however, still problem areas and we must continue this annual awareness campaign until we can show that no appointments are unnecessarily missed."

More than two-thirds of doctors believe that the majority of appointments are missed because patients simply forget they have made one. One in four say that patients also fail to turn up because they feel better before their appointment.

The Keep It Or Cancel It campaign includes new guidance for GP practices to help them manage missed appointments. Posters will also be distributed to surgeries, urging patients to make a note of their appointment and to remember to cancel it if they no longer need to see a doctor.