DNA – Did Not Attend Policy
A 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.
Wasted appointments are a huge problem throughout the NHS. The issue of Did Not Attends (DNAs) is a continued frustration for both patients waiting to get an appointment with their GP or Nurse and for those working in the Practice.
Cam and Uley Family Practice, in an attempt to try to improve and rectify the problem has therefore, agreed the following policy:
The appointment system is monitored daily to search for patients who have 'DNA’ appointments which they booked for the GP's and Practice Nurses.
Notifying the Practice:
- Patients must notify the Practice as soon as possible, at least the day before their appointment, should they need to cancel by ringing our reception team on 01453 540066 or via Systmonline.
- If an emergency situation means a patient cannot attend their appointment on the day, patients must ring as early as possible on that day: before the appointment time, to notify the reception team. This appointment can then be offered to another patient.
Failing to Attend Without Prior Notification:
- When a patient fails to attend an appointment with a healthcare professional a note of the date and time is made in their electronic medical record.
- When a patient fails to attend 3 appointments with a healthcare professional within a 12 month period, the Practice Manager will write to the patient, reminding them of the importance of first cancelling unwanted appointments and detailing the consequence of not cancelling. This letter will also explain to the patient, that should they fail to attend a further appointment without prior notification, they risk being removed from the Practice list.
- If the patient fails to attend a further appointment following receipt of the first letter, the Practice Manager will write to the patient with a warning that any future failure to attend an appointment without prior notification will lead to their removal from the Practice list.
- If a patient fails to attend a pre-booked appointment on one occasion, they are automatically sent a text message, via TPP and maybe an informal warning letter will also be sent. (Appendix A).
- This letter will be printed by the Duty Receptionist and posted to the patient.
- Where this is the first occasion, The Practice will code this DNA on the patients’ medical record 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 on the part of the GP (more GP time) will often be required by the hospital department so that the Patient can be recalled.
- The read code added to the Patient’s medical record will show the DNA when the monthly audit is run.
- If the patient fails to attend another appointment within a 12 month period, the Patient will be contacted by the Practice, to be made aware of the missed appointment and a ‘Flag’ screen will be added to their record.
- When the Patient makes a further appointment, they will be advised by the Receptionist that the Practice is aware of their previous DNA and they will be asked to confirm their intention to attend their next appointment.
- A formal warning letter will be sent reminding them that should they miss another appointment they risk being removed from the practice list (Appendix B).
- Where a third DNA has occurred, within a 12 month period, the Practice will review the individual case along with a Senior GP and a decision will be taken with regard to addressing the Patient’s future ability to pre‑book routine appointments.
- The Practice will consider whether consistent failure to adhere to Cam and Uley Family Practice policy constitutes a breakdown between the Patient and the GP (where the GP Practice has given clear instruction on policy and service provision and the Patient has chosen to disregard this on several occasions in spite of due warning).
- The Practice Manger and Senior GP will make a decision as to whether the patient is removed from the practice list.
- Warning letters are only valid for a period of 12 months, removal based on warning greater than 12 months old will be invalid.
- In such a scenario only the DNA appointments within a 12 month period may be reviewed to determine which stage of the policy should be applied.
How to avoid becoming a DNA
If you cannot attend or no longer need an appointment, please ring us in advance. Mistakes do happen and the Practice understands that appointments can be forgotten about or overlooked. In such cases, the Practice will take into account the reason given by Patients. Preference, of course, is for the Practice to know in advance so we can offer the appointment(s) to other Patients in need.