We conducted a 1-year retrospective study of attendance at a general National Health Service psychiatric clinic in London between 2005 and 2006. We aimed to compare attendance rates between grades of doctors and identify demographic and organisational factors affecting attendance. Previous publications on the subject had identified relatively poor attendance in psychiatric clinics compared with other medical specialties (Reference KillaspyKillaspy, 2006) and variation between different grades (Reference McIvor, Ek and CarsonMcIvor et al, 2004). Little improvement had been noticed between 1969 (Nehama) and 2004 (McIvor et al), taking into account the variation in settings and significant changes to the structure of mental healthcare in the UK. In our study, we looked at the clinics covered by 13 doctors with various degrees of seniority and experience. Appointments were set for 30 min on average at a community hospital in a suburban area with good transport links. The overall attendance rate was 72.4%, ranging between 79.1% for consultant psychiatrists and 63.8% for associate specialists, with intermediate figures for specialist registrars (72.3%) and senior house officers (66.3%). We also found significantly better attendance for morning clinics and on Wednesdays. There was no significant difference between male and female service users or between new and follow-up appointments. Most missed appointments were an isolated event but a small number of service users (n=61) were responsible for 38% of overall non-attendance, having missed between 3 and 12 appointments in that year.