No. In England, the NHS dental contract does not let a practice charge a patient for a missed NHS appointment, and a single missed appointment is not grounds for removing them. What you can do is run a fair, consistent failure-to-attend (FTA) process, take repeated non-attendance into account, and cut the number of FTAs before they happen.
Private treatment is different. A private patient can be charged a missed-appointment fee they agreed to in advance, as long as it is proportionate.
Can an NHS dentist charge for a missed appointment in England?
The British Dental Association is clear on this. Its advice for practices in England, updated for the April 2026 contract changes, says the contractual framework "continues to prohibit charging NHS patients for missed appointments" and that a single failure to attend is not grounds for removal from the patient list (BDA, 2026).
The same guidance adds the part most practices care about: repeated non-attendance "can reasonably be considered" when you assess whether you can keep offering that patient appointments safely and effectively. The condition is process. The BDA stresses a consistent, fair and transparent procedure, accurate records and clear communication with the patient.
It was not always this way. Dr Joe Hendron, vice-chair of the BDA's general dental practice committee, said his practice's missed-appointment rate was below 5% before the 2006 contract removed the ability to charge, and rose to about 15% in the first year afterwards. He told the BBC that around one in seven NHS patients had missed appointments at his practice over the past year, costing an estimated £56,000 (Dental Tribune, 2026; GDPUK). That is one practice, not a national figure, but it shows why the question keeps coming up.
What can an NHS practice do instead?
Since you cannot charge, the job is to make a missed appointment less likely and to deal with repeat offenders fairly. A workable FTA procedure looks like this:
| Step | What to do | Why it matters |
|---|---|---|
| 1. Tell patients the policy | Put your FTA policy on your website, in the practice and in booking confirmations | Patients cannot follow a rule they never saw |
| 2. Remind before every appointment | Send reminders at more than one point before the visit, with an easy way to cancel or move it | A cancelled slot can be refilled; a no-show cannot |
| 3. Record every FTA | Log the date, appointment type and any contact or explanation | The BDA stresses accurate records |
| 4. Contact after a first FTA | A neutral message: you missed your appointment, here is how to rebook | Many FTAs are genuine mistakes |
| 5. Warn in writing after repeats | Explain the policy and what happens if it continues | Gives the patient a fair chance |
| 6. Decide consistently | Apply the same thresholds to everyone, and allow for genuine reasons | A decision you can justify if challenged |
Two things to watch. First, consistency: a policy applied to some patients and not others is hard to defend. Second, vulnerability. Some patients miss appointments because of illness, caring duties or anxiety, so build in a point where a person looks at the circumstances before anything is decided.
Can a private dental practice charge for a missed appointment?
Yes. Private dentistry is a private contract, so you can agree a missed-appointment or late-cancellation fee with the patient. The limit is fairness. The Consumer Rights Act 2015 lists, as terms that may be unfair, a term requiring a consumer who does not perform the contract to pay "a disproportionately high sum in compensation" (Consumer Rights Act 2015, Schedule 2).
In practice that means:
- Tell them before they book. Put the fee in your terms, on your website and in the booking confirmation.
- Make it proportionate. A fee tied to the length or value of the lost appointment is easier to justify than a flat penalty.
- Give a clear notice period. Patients should know how much notice avoids the fee, and how to give it.
- Apply it the same way every time, with discretion for genuine emergencies.
A deposit for longer private treatment, taken at booking and counted towards the bill, often works better than a fee chased afterwards, because there is nothing to collect later.
What about a mixed NHS and private practice?
This is where mistakes happen. A charge can only apply to private treatment the patient agreed to on private terms. If your reminder system sends the same "a fee applies if you miss this appointment" wording to everyone, NHS patients will be told about a charge that cannot apply to them. Label appointments clearly as NHS or private in the diary, and make sure reminders and policies follow the label.
Does reminding patients actually help?
Reminders do not fix every FTA, but they deal with the most common one: the patient who simply forgot. They also turn some no-shows into cancellations, and a cancellation made a day ahead can be offered to someone else. The key is making it easy to reply. If the only way to cancel is to ring during opening hours and wait in a queue, many patients will not bother.
This is the part of the problem Remi was built for. It sends reminders 48 hours, 24 hours and 2 hours before each appointment, and answers calls and WhatsApp messages at any hour, so a patient who realises at 10pm that they cannot make it can cancel or rebook there and then. On the Complete plan it can also offer freed-up slots to patients on your waiting list. If you want to see how that fits a dental diary, here is how an AI receptionist built for dental practices handles bookings and cancellations.
Checklist: an FTA policy you can defend
- Written policy, published on your website and in the practice
- NHS and private appointments clearly labelled in the diary
- Missed-appointment fees mentioned only for private appointments
- Reminders before every appointment, with an easy way to cancel or rebook
- Every FTA recorded, with any explanation the patient gives
- Written warning before any decision about future appointments
- Same thresholds for everyone, with room for genuine reasons
- Policy reviewed whenever the NHS contract or BDA guidance changes
The short version
In England you cannot charge an NHS patient for a missed dental appointment, and one missed appointment is not grounds for removal. You can take repeated non-attendance into account, provided you follow a consistent, fair and well-recorded process. Private patients can be charged a fee they agreed to in advance, as long as it is proportionate to your loss. Whatever your mix, the most reliable way to protect your diary is to make cancelling easy and to remind patients before every appointment.