Approximately 200 appointments per month are classified as ‘Did Not Attend’ (DNA) – i.e. the patient did not turn up for the appointment and did not contact the surgery in advance to cancel/change appointment. The effects of these are:
- An increase in the waiting time for appointments.
- Frustration for both staff and patients.
- A waste of resources.
- A potential risk to the health of the patient.
If a patient fails to attend a pre-booked appointment on more than three occasions in the space of 12 months, an informal warning letter will be sent to the patient, advising them that a further occurrence could risk removal from the practice. If the patient fails to attend another appointment within 6 months, a formal warning letter will be issued advising that any further DNA’s may result in removal from the list. Should the patient DNA a further appointment within 12 months then the matter will be discussed at a practice meeting and a majority agreement will be reached as to whether the patient will be removed from the practice list.
Warning letters are valid for a period of 12 months. Removal based on warnings greater than 12 months old will be invalid – in this case a further formal warning and period of grace will be required.
The practice policy is to send 3 letters of invitation for screening either by SMS messaging, phone call, messaging via repeat prescriptions or post. The responsible clinician (usually the doctor or the nurse holding the clinic) will be responsible for initiating action to contact the patient by telephone to determine the reason for the failure to attend where the patient is vulnerable or there are concerns about the welfare of the patient.
The DNA must be coded onto the clinical system at each non-attendance. The administrator will be responsible for the issue of a monthly DNA clinical system report by clinician for clinician review. This will be displayed in the waiting room and on practice social media sites.