On average at present the Practice is experiencing missed appointments, that can equate to one full time Clinician each month.
We recognise that patients can as a consequence of busy lives or an unexpected event, forget about an appointment until after the event. These patients are usually apologetic, rebook and it does not occur again. However, there are a minority that will frequently DNA (miss their appointment) and do not appear to understand the impact it has on other patients that could have been offered the appointment that was missed without cancellation. So, we are introducing a policy that will hopefully change the behaviour of patients who miss their appointment without cancelling and allow us to offer these appointments to other patients.
The outcome we are hoping for is to…
· Reduce the number of DNAs
· Find a solution to the common reasons why people DNA
· Help people who frequently DNA to find solutions to why they DNA
· Free up wasted appointments which are lost by people who DNA
· Encourage patients to keep the surgery informed of any problems
· Encourage patients to cancel appointments if they cannot attend
· Make allowance for those patients who DNA because their lives are in turmoil (e.g. vulnerable patients).
Alnwick Medical Group Protocol – Missed Appointment / DNA
Patients who DNA three times with a period of 6 months between each missed appointment may be removed from the list if their behaviour cannot be adequately justified or changed. Therefore, if a patient DNA’s an appointment:
· 1st DNA occurrence, Admin will send a 1st missed appointment letter via Accurx where possible or letter by post, to the patient informing them of their DNA, suggesting they keep a diary/calendar and opt into our SMS service.
· 2nd DNA occurrence in the preceding 6 months, Admin will send a 2nd missed appointment letter to the patient via Accurx where possible or letter by post, informing them of this DNA, also informing the patient that they might not be able to stay with the practice if further DNA occurs.
· 3rd DNA in preceding 6 months, Admin will inform the Practice Manager who will consult with the Partners. The Partners will review any reason for DNA and discuss potential removal from the Practice list. The aim here is to see if there are any clinical issues that might help put the DNA’s into context (e.g. patient vulnerability issues) and to understand if we need to adopt a more flexible approach and provide assistance to an individual patient in supporting attendance. The outcome will be to decide whether to remove the patient from our Practice list or not.
NOTE: If the second & third DNA occurs within 2 weeks of the previous occurrence, we will take into account the timing. In other words, the possibility that the patient may not have received the first letter and hence may may not have had the time or the chance to change their behaviour. In which case, we may wish to overlook the subsequent DNA occurrence on this occasion and review matters if it happens again.
Other actions to reduce DNA’s:
•Information regarding our approach to DNA’s will be communicated to Patients via: notice in Waiting Rooms, on the Practice Website, on the Practice Facebook page.
•Patients will be sent appointment reminders asking them to cancel if the appointment cannot be attended, supplying a link to make the cancellation
•Reception staff will inform Patients’ at the point of booking an appointment on the telephone that they should cancel if they are unable to attend in order that we can offer the appointment to another Patient
•Reception staff will confirm with Patients’ at the point of booking an appointment on the telephone that they are happy to have the appointment reminder activated and activate this
•Missed appt numbers from DNAs will be communicated to Patients monthly in order to educate patients by posting DNA numbers in each waiting room / on the Practice website / on the Practice Facebook page
•Staff will continue to consider rearranging appointments to those Patients who miss:
Long Term Condition Reviews
Medication reviews
Other routine reviews
Opportunistically, we will encourage patients:
• to inform us if they cannot make the appointment, prompted by the appointment reminder
• to contact the surgery if they are late rather than not attending, as the appointment; may be offered the same day but at a different time if it can be fitted in; be cancelled; or other arrangements may be able to me made
• to keep appointments where possible
• to inform the surgery of any issues, problems or complaints to enable them to be dealt with quickly
We do hope that our patients will understand our approach to this, the reasons why we are doing this and will support us in these actions.
MISSED APPOINTMENTS
