DID NOT ATTEND (DNA) POLICY

Background

Most patients will be aware that the NHS is currently facing many challenges and Saxmundham Health is not immune to these challenges. The waiting time to see a GP or Nurse for a routine appointment is currently longer than we would like it to be and we are working hard to try and reduce these waiting times.

One thing that makes this problem more difficult to overcome is the problem of missed routine appointments – ‘did not attend’ (DNA).
Patients may have had to wait a number of weeks for a routine appointment, this alone is disappointing, however when a patient fails to attend one of these booked appointments it is a waste of resources.  By not contacting the Practice to cancel the appointment, we are unable to release or allocate the appointment to another patient.

During 2018, at Saxmundham Health there were 1006 such DNAs with either one of our GPs, Nurses or one of our specialist clinics. This means on average approximately 4 appointments a day are missed and ultimately wasted. There is a cost in both time and money and at a time when we are looking at how best to resource the Practice we can no longer sustain this waste of resources.

Please remember that your DNA is a further stretch on our ability to manage demand for services.

What we currently do to help Patients avoid DNAs

1. For those patients who have supplied their mobile phone number we send a text to remind them of their upcoming appointment.
2. For patients known to have memory difficulties we aim to telephone them in advance of their appointment.
3. We have an online appointment cancellation option which automatically links to our appointment calendar.
4. We ask the patient to repeat the time and date of their appointment over the phone.
5. We provide a printed out appointment card if an appointment is made at reception.
6. Appointments booked via our online booking facility can be saved directly into your electronic diary.
7. At reception we display how many appointments are missed and this is updated on a weekly basis.
8. We are reviewing the timings of some of our specialist clinics. For example many children of school age would find the asthma clinic easier to attend if it was outside of usual school hours.

What is our policy towards patients who do not attend appointments?

A DNA occurs when appointment is not attended and the Patient has not contacted the Practice in advance to cancel it or where the cancellation is so late as to make it impossible to allocate to another Patient who needs treatment. Whilst we are primarily concerned with our own appointments consideration may also be given to any hospital appointments where we have been notified that a Patient has failed to attend. A re-referral on the part of the GP (more GP time) will often be required by the hospital department so that the Patient can be recalled.

DNA 1
When a patient first DNA, an alert will be added to the Patient’s medical record along with the date of the DNA. 

DNA 2
Where this is the second occasion the Patient will be sent a questionnaire which will help the Practice understand these missed appointments and possibly allow us to remove any obstacles to either attendance or failure to inform us. If this questionnaire is not returned then the Practice will make contact directly with Patient and complete the form over the phone. The Patient will also be sent a copy of this policy to ensure they are aware that further appointment DNA’s could result in them compromising their relationship with the Practice and possibly being asked to register with an alternative Practice.
When the Patient makes a further appointment they will be advised by the Receptionist that the Practice is aware of the previous DNAs and asked to confirm their intention to attend their next appointment.

DNA 3
Where a third DNA has occurred, the Practice will review the individual case and will make a decision at the next Partners meeting on how best to address the Patient’ future ability to pre-book appointments. The Practice will also consider whether consistent failure to adhere to our Practice policy constitutes a breakdown between the Patient and the Practice. The Practice will consider the effort that it will have put into giving clear instruction on this Policy and how the Patient has chosen to disregard this on several occasions in spite of warnings on possible consequences. In simple terms this could mean the Patient is asked to find another Practice.

SHOULD YOU NEED TO CANCEL HERE’S HOW:

1. By telephone - 01728 602022 (option 6)
2. Online through Patient Access