Intro
The practice recognises that patients can forget about an appointment until after the event, often due to busy lives. These patients are usually apologetic, embarrassed, rebook and it doesn’t occur again. However, there are a few patients that frequently do not attend (DNA), and do not appear to understand or accept the impact it has on access to services for other patients. We therefore have a policy that tries to change the behaviour of the more frequent DNA’ers.
The purpose
The outcome we are hoping for is to…
- Help to reduce the number of DNAs
- Find out a solution to the common reasons as to why people DNA.
- Help people who frequently DNA to find solutions as to why they DNA.
- Free up wasted appointments which are lost by people who DNA.
- Encourage people to keep the surgery informed of problems.
- Encourage people to cancel appointments if they cannot attend.
The protocol
Essentially: patients who DNA three times or more in a 6 month period may be removed from the practice list if their behaviour cannot be adequately justified or changed. Therefore, if a patient DNA’s an appointment (with either doctor, nurse or other associated clinician)….
- 1st DNA occurrence – Patient will be sent DNA surgery appointment 1st letter informing of DNA with a reminder to cancel if unable to attend.
- 2nd DNA in past 6 months – Patient will be sent DNA surgery appointment 2nd letter
- 3rd DNA in past 6 months – Patient will be sent Surgery Appointment 3rd letter – this will then escalate to the GPs to discuss the reasons for the missed appointments and any potential barriers to attending. The aim here is to see if there are any clinical issues that might help put the DNAs into context (like mental health issues) and thus help us to adopt a more flexible approach. The ultimate decision is whether to take off our practice list or not. It will be the GPs decision whether patient remains registered, and the decision will be a final decision.
If a patient is listed for a telephone triage appointment, the GP will attempt to call the patient. If there is no reply to the first call, the GP will try again to engage with the patient. If there is still no reply then this will be documented as a DNA appointment and this will be recorded in patient’s notes and a letter sent to patient accordingly.
Cancelling and re-scheduling
- Patients are encouraged to cancel or reschedule appointments as soon as possible, ideally with at least 24 hours notice
- Cancellations can be made via phone, text message, or in person at the practice
Updating contact information
- Patients are responsible for ensuring that their contact details are up to date to receive appointment reminders
Safeguarding
- For children and vulnerable adults, a missed appointment may indicate potential safeguarding concerns. The practice will follow appropriate safeguarding procedures in these cases
Complaints
Complaints about access and other issues should be channelled through the normal complaints process.