Approximately 300 to 400 appointments per month are ‘Did Not Attend’ (DNA), i.e. the patient does not turn up for the appointment and does not contact the surgery in advance to cancel/change appointment. The affect 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 one occasion in a 12 month period, an informal warning letter along with the practice policy will be sent to the patient. If the patient fails to attend a second appointment in the same 12 months, a second letter will be sent, advising them that a further occurrence could risk removal from the practice.
If the patient fails to attend a third appointment, the matter will be discussed with one of the partners as to whether the patient will be removed from the practice list. In which case a formal warning letter will be issued.
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.
Where a patient with a chronic condition or is otherwise deemed to be “at risk” fails to attend a screening or a recall appointment there may be an implied duty on the practice to follow-up the reason for non-attendance to ensure that the patient’s health is not at risk.
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, and where possible re-arrange the appointment.
Where a new appointment is arranged, this is to be followed up with a letter of confirmation, and, the day prior to the new appointment date, a further telephone call to the patient is to be made to check that they will attend.
The clinician will have overall responsibility for the individual patient follow-up and attendance, although the administration aspects may be delegated.
The DNA must be coded onto the clinical system at each non-attendance.
The Assistant Reception Manager will be responsible for the issue of a weekly DNA clinical system report by clinician.