This project investigates the intelligence from clinical practice that serially missed GP appointments are important determinants of health outcomes and a proxy for health and social vulnerability. It examines the relationship between general practice appointment attendance, health care utilization, preventative health activity, health outcomes, social circumstances and education outcomes taking a life course approach. It defines never, occasional and serial missed appointments and links data from 3 cohorts of patients from approximately 200 general practices in Scotland with health, social work and education data. Its epidemiological findings will form the basis for targeted interventions development including informing an adjustment for unmet need in the Scottish NHS health funding formula.