Overview

When a patient fails to attend an appointment or fails to notify this organisation 24 hours prior to the scheduled appointment of the need to cancel or change the appointment, it is referred to as a Did Not Attend (DNA) or Was Not Brought (WNB). 

Recording DNAs

All DNAs are to be recorded on the clinical system in the individual’s record using the relevant “did not attend” code (Did not attend (Xa1kG))

This organisation will review DNA statistics on a regular basis, presenting this information at the relevant internal meetings.

• Easy cancellation: Rapid access is provided for patients who wish to contact the organisation to cancel an appointment, such as the NHS App, a dedicated phone number, and a text message service.
• Appointment reminders: Patients are sent a text message to remind them about a forthcoming appointment. The reminder includes an explanation of how to cancel the appointment if it is no longer wanted.
• Patient information leaflet: This will detail the policy for dealing with patients who fail to attend their appointments.

Managing DNAs

Should a patient fail to attend their appointment without notice, this will be recorded as – “Did not attend” with a flagged reminder on the Home screen. It should be noted that, while unacceptable in most cases, there may be extenuating circumstances as to why the patient failed to attend their appointment. Therefore, prior to any letter being sent to a patient, it would be reasonable to discuss this with their clinician. 

As a result of a second DNA (should there not be any mitigating reasons) a letter highlighting the DNA will be sent to the patient. This letter should make clear that the patient may be removed from the patient list if any further DNAs take place

Should the patient then fail to attend a third appointment within the same 12-month period, a decision will be made by the management team as to whether the patient is to be removed from the organisation’s list.

Children who fail to attend

The BJGP explains that while all missed appointments have traditionally been classified as a DNA, this group needs to be classified as Was Not Brought as it is not a child’s responsibility to attend the appointment; it is the responsibility of their parents or carers to take them. Awareness must be given to this and the consideration that this could be termed as medical neglect.  See Safeguarding Policy regarding the follow-up procedure

Exclusions

No patient will be removed from the practice list without due consideration of their individual circumstances and reasons for non-attendance. The purpose of this policy is not to penalise patients with valid medical reasons for non-attendance.

If the practice is aware of special circumstances surrounding a patient’s non-attendance, for example, patients who have been admitted to hospital or have dementia, the medical team reserve the right to exclude the patient from management under this policy.

Patients concerned regarding their management under this policy or who are having problems attending should speak to the surgery. Lack of organisation or forgetting is not an acceptable reason for non-attendance.