Missed appointments policy (DNA)

Last Updated: Thursday, 16 November 2023

Did not attend (DNA) overview

A Did Not Attend (DNA) occurs when an 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 that time to another Patient who needs treatment.

The Practice will code this DNA and this will prompt a retrospective check on the number of DNAs recorded against that person.  Whilst we are primarily concerned with our own appointment observance, consideration may also be given to any hospital appointments where we have been notified that a Patient has failed to attend.

A re-referral having to be made by the GP (more GP time) will often be required by the hospital department so that the Patient can be recalled.  Where this is the first occasion, a code will be added to the Patient’s medical record and the DNA counted in a monthly search.

What happens when patients miss appointments?

We realise that everyone can make mistakes and therefore we won’t take any action if a single appointment is missed in error.  However, we have a minority of patients who miss appointments regularly and this can impact significantly on other patients.  We have a policy in place to take action in these circumstances which has been fully approved by our Patient Participation Group.

If a patient misses an urgent appointment booked the same day, or if a patient misses TWO non-urgent appointments in a 12 month period: 

In these instances we shall send a letter to the patient explaining the problem that we have with appointments being missed and the impact that this has on the service we provide to the rest of our 6,500 patients.

We list the appointment (s) that were missed and offer the opportunity to discuss if the patient feels this is incorrect.  The letter goes on to insist that in the future, they call to let us know if they cannot attend a booked appointment.  The letter also advises the patient that instead of phoning the surgery they can cancel an appointment via patient online services or if they’ve received a reminder text, simply reply with the word “cancel”.

If a patient goes on to miss a further appointment within 6 months of the first letter being sent:

The patient will receive a letter expressing disappointment and notifying them that their continued registration at the practice will be reviewed by the GP Partners in their next meeting.  Patients are invited to write or telephone to explain any mitigating circumstances which will be considered.

In cases where no improvement is seen and there are no mitigating circumstances, we will consider removing the patient from the practice list.