Three-strike rule and fines among ideas to clamp down on no-shows after 38,000 appointments missed in Sunderland

Echo readers have had their say after we reported on Thursday how tens of thousands of patients failed to turn up in just 12 months in the city - costing services £1.14million in the process.

As well as commenting on our story, 86 per cent of you responded to a separate poll to say that no-show people should be fined to deter similar lapses.

Related: Why missed appointments are such a nightmare for GPs: One Sunderland surgery shares its story.

Among those commenting on our story was Kristina Burns Blenkinsop, who said: "My dentist does a three-strike rule. I think that should apply everywhere.

"Some people have memory problems/mental health issues that can confuse dates/times so it's not down to laziness for most patients.

"The NHS now do reminder texts the day before or day of appointment but only if requested. This needs to be advertised more."

Karen Ramshaw added: "This is why nobody can get an appointment."

Related: An eye for an eye? Why we’re just not tough enough on the ignorant masses missing NHS appointments.

Jo Lavender maintained: "It's not that hard to cancel. Just lazy folks."

Karen Johnson said: "People should be billed a tenner for each missed appointment unless they call to cancel beforehand."

Angela Wind commented: "(They should) if there is no valid reason."

However, some people had reservations over introducing a fine system and how it might work.

Gemma Errington said she supported the idea of introducing fines but that health service providers must make sure their systems were accurate and working well.

"I got a letter from my GP surgery recently saying I hadn’t attended two appointments and cost the NHS x amount of money. I had rung up myself and cancelled both of them," she said.

Mark Kenny said: "I got sent a written letter notifying of me of my appointment. They sent the letter the day before the appointment, so I received it as I got in from work on the evening of the day my appointment was."The NHS needs to update that system. That was not my fault."I fully support that the NHS needs funding - I do believe that this instance was more a symptom of how stretched the NHS is and how they need funding to update the operational systems."

Christopher Ingram added: "(I agree with it) as long as it doesn’t outweigh both the lost time and the cost of administration to follow it through."