The huge drain on the NHS's hardpressed budget was revealed as ministers published the fourth annual set of performance tables for the service which show pressures growing.
The total number of starred ratings indicating good performance is down on last year and cancelled operations not re-scheduled within a month - a sensitive indicator of hospitals in difficulty - are up almost 40 per cent.
Launching the tables, which are to be extended to include death rates and other clinical measures, Baroness Jay, the health minister, said she had been shocked by the number of patients who missed hospital appointments. They average 11 per cent across the NHS, but rise to more than one-third in some hospitals.
She said 1.3 million first out-patient appointments were missed each year at a cost of almost pounds 200 each, equivalent to pounds 250m. In addition, 250,000 patients failed to turn up for booked operations or day case surgery at an average cost of pounds 1,000 each, worth another pounds 250m. "We are seeing enormous sums being lost to the service," she said.
Some of the no-shows were accounted for by patients who died, got better or whose circumstances changed. Alan Langlands, chief executive of the NHS, said hospitals that phoned patients the week before they were due to come in improved attendance.
"There is a responsibility on patients to keep appointments and an important job for hospitals to ensure patients are reminded," he said.
Lady Jay said the existing performance tables, which assess hospitals across more than 70 indicators including waiting times, day surgery and cancelled operations, measured the quantity, but not the quality of treatment. She announced trials of 15 clinical indicators including deaths in hospital within 30 days of admission with a heart attack, infection rates and readmission rates. Some existing measures would be replaced including how rapidly patients are assessed in accident and emergency departments by what is disparagingly referred to as the "hello nurse".
The new clinical indicators, which were piloted last year under the Tory government, would be introduced as soon as possible, probably by next year, Lady Jay said.
Medical organisations welcomed the move, but warned that like must be compared with like. The NHS Confederation said: "The current tables lack credibility because they fail to give the public any indication of the success of their local hospital."
One of the most improved NHS trusts, which increased its star rating in 23 categories, is Redbridge in east London, which runs the 450-bed King George hospital and three other smaller hospitals. The trust attributed its success to hard work in areas identified in previous tables as weak, such as out-patient waiting times.
GOOD PERFORMERS Most improved NHS trusts which have performed well across the range
Redbridge Healthcare NHS Trust
Mid-Essex Hospital Services NHS Trust
Wiltshire Healthcare NHS Trust
Stockport Acute Services NHS Trust
Mid-Staffordshire General Hospitals NHS Trust
City Hospitals Sunderland NHS Trust
Southend Healthcare NHS Trust
South Warwickshire Healthcare NHS Trust
Heathlands Mental Health NHS Trust, Surrey.
North Hampshire Loddon Community NHS Trust
NHS trusts and health authorities with poor records on certain measures
Newham Healthcare NHS Trust
Royal Hospitals Trust, east London
Royal Liverpool and Broadgreen NHS Trust
Northwick Park and St Mark's NHS Trust
Bournewood Community and Mental Health NHS Trust, Surrey
South Yorkshire Ambulance Service
Lewisham and Guy's Mental Health NHS Trust
BHB Community Mental Health Trust, Essex
Kensington and Chelsea Health Authority
Lambeth, Southwark and Lewisham Health AuthorityReuse content