Hundreds of patients a month are not turning up for appointments at GP surgeries in Sussex.

The cost to practices is calculated to run into hundreds of thousands of pounds, according to research by campaigners.

Developing Patient Partnerships and the Institute of Healthcare Management believe each missed appointment costs a practice about £18. Campaigners say patients forget they have an appointment with a doctor or practice nurse and so do not call to cancel.

GP practices and primary care trusts are calling on patients to make sure they let their surgery know whether they are not going to be able to turn up.

Repeat offenders are at risk of being taken off a practice's books and others are considering the possibility of bringing in fines for those who persistently do not turn up.

A new booking system aimed at making sure patients get access to a GP or nurse within 48 hours has helped cut the number of missed appointments but work still needs to be done. Many practices now do not let patients book in advance and instead they phone on the day for an appointment.

Others have kept the old system of booking appointments well ahead but have introduced an emergency surgery held every day for urgent appointments.

The changes have helped but primary care trusts and practices around the county say more work still needs to be done.

A spokeswoman for Mid Sussex Primary Care Trust said: "Our practices all operate systems where patients book on the day. We are not getting complaints from GPs about missed appointments but obviously there are still occasions where people do not turn up. We cannot say it has been completely eradicated.

"Either the patient forgets or perhaps feels a bit better and decides not to keep the appointment. We would urge people to make sure they let the GP surgery know if they are not going to come along because then someone else can use that space."

The researcher's survey of 683 surgeries in the UK found that 71 per cent said they would consider removing patients from their lists if they repeatedly missed appointments.

More than two thirds of surgeries, 67 per cent, also supported the idea of charging patients for missed appointments.

Most surgeries, 84 per cent, believed missed appointments increased waiting times in the practice and 98 per cent said they were a waste of NHS money and resources.