View Full Version : Late/non attending patients

12-01-2007, 10:14 AM
An age old problem i know!

Does any one have any innovative ways of reducing the numbers of patients who turn up late or don't attend.

We have always been quite lenient, but the time has come for a change.

12-01-2007, 11:43 AM
We have an open access service every morning ~ persistant non-attenders are told that they can only be seen at this clinic. We have a list of patients who should not be offered appointments.
It is a problem for the nurses though because they only have scheduled appointments. We write to patients who have more than 3 consecutive missed appointments. If the behaviour persists we remove them from the list.
Patients who make a habit of being late are asked to reschedule as this keeps everybody late.
Hard as nails eh? :D

12-01-2007, 01:38 PM
We have a DNA policy of 2 consecutive DNA's inviting in to explain reason and a warning a third could result in removal from list (including other household members if children). In real terms I have only removed one family in 5 years. We are looking at texting known pts the day before their appointments via nhs.net.

17-01-2007, 12:13 PM
Huge problem here. We have 180 - 200 DNA's per month for the GP's and Nurses.

We write to patients each time and 3 strikes and they are off the list. Unfortunately they don't seem to care. They know they will be allocated another GP anyway. We chuck off about 2 - 3 families per month


Brenda Netherton
05-03-2007, 12:25 PM
An age old problem i know!

Does any one have any innovative ways of reducing the numbers of patients who turn up late or don't attend.

We have always been quite lenient, but the time has come for a change.

If the patient is very late and they have a good reason why, the GP will see them at the end of surgery, otherwise they are requested to make another appt. If the patient DNA's twice they get a warning letter stating that if they do not turn up for next appt. (making 3) they will be de-registered but will be given the details of PPSA for finding another GP.

31-03-2007, 11:18 AM
We have a dedicated voicemail for patients to cancel. Thus the excuse of "I couldn't get through" is no longer valid. We are now getting as many as seven or eight cancellations per day on this most of which are successfully re-booked. There is nothing nicer than coming in first thing in the morning and finding two spare apppointments that patients have cancelled ( voicemail is available out of hours).

Persistent offenders are restricted to booking same days only. This really irks them and after a year of this they usually mend their ways.

We have also started text messaging patients.

We used to have a policy of threatening removal from the list-"three strikes and your out" but as far as I can see it may make us feel better but does not alter patient behaviour one little bit. Also the patients will just dna somewhere else.

As we recently migrated to a new clinical system we haven't got up to date reliable data on how successful we are being in our efforts, but will post here in a few months to see if we have been successful.

02-04-2007, 01:29 PM
Dealing with lateness can be a problem if the doctor is running late (as I often am!), but if they arrive so late the next patient has been called, then they should be sent away and have to rebook. I agree the "three strikes and you're off the list" is just moving the problem to another practice and I wonder how many of your chronic DNAs have recently arrived on the list from another practice with a similar policy?
An invitation to explain the non-attendance is likely to be ignored. How is the DNA dealt with next time they do turn up? Has it been recorded, and where? Does the doctor who subsequently sees them know that they've DNAed before? I always have it recorded in front of me if they've DNAed and ask them why. It probably has more effect coming from the doctor than from the Receptionist, or a letter from the Practice Manager, which can go into the bin.
"I forgot" should mean same day bookings only. A good reason should get a lecture on the courtesy of letting you know - even after the event with an apology.
Our Physiotherapists and Chiropodists have started putting a poster up in the Waiting area with numbers of wasted appointments, and a sort of implied message "the reason you've had to wait so long to see us is that there are a lot of timewasters out there"!
Andrew Hamilton, Unst, Shetland.