View Full Version : Dna

15-09-2006, 11:15 AM
hiya all!

just wondering if anyone has a policy for patients that do not attend. there are DNA codes on EMIS LV but i read somewhere that we should only use them after the 3rd DNA. does anyone know about that? what i've found so far from elsewhere is the following policy...

* Letter written to patient after 1st/2nd or 3rd DNA
* Receptionist/GP to ring patient after DNA
* GP to speak to patient at appointment following after DNA
* Posters in reception area reminding patients not to DNA
* Reminder in practice newsletter

does anyone know anything about the coding?

15-09-2006, 11:52 AM

Its a constant problem.
We send a letter after the 3rd DNA in 6 months and if there are any further DNAs in the next 6 months my executive partner and I decide on what course of action to take. We have the options of:
Do nothing (if there are clinical or social reasons for the DNAs such as elderly patients with memory problems)
Send a second letter warning we will take action against them
Restrict their ability to book appointments ahead
Stop them booking appointments entirely. they have to come and wait to see the on call GP at the end of surgery
Remove them from our list.
generally speaking people who DNA have chaotic lives and and don't repond much to letters. If you throw them off the list you're just moving the problem on. We've pretty much stopped doing that, although we will if the docs get exasperated.
Ed H

chhaya shah
15-09-2006, 01:09 PM
You need to remind patient to attend clinic THREE times and than enter exemption code, i.e exclude them from clinic. Can Invite verbal, over telephone or by sending them letters or can use SMS service. every time should enter code of invitation and in EMS LV all DNA codes are given, so pick right code and add entry.
I have no difficulty in DNA's code. Another way to enter by MACRO, just one click, this can be done daily by receptionist.
If need help to creat MACRO contact EMIS support

15-09-2006, 02:01 PM
I have attached our DNA guidelines that we follow; we have posters up to advise patients about the effects of DNA's. It has not been necessary to remove many patients (probably one or two) after they have been sent the initial letter so the threat of not being able to make advance appointments works for us. If you would like a copy of the sample letter just let me know.


15-09-2006, 02:16 PM
Hi our policy is that each time a patient does not attend Dr or Nurse records it ( I think read code is 9N42). a member of staff checks rates of dna and after 3rd dna patient receives stat letter asking if any problems and asking the to speak to reception manager if a problem. Once 1st letter has been sent, if patient dna's again they receive a further letter asking themtomak an appointment with practice manager and stating that failure ti contact surgery may result in their removalfromthe list. This usually does the trick and they contact us


julie walsh
18-09-2006, 09:17 AM

we code all DNA's and after the 3rd recorded in 12mths we send along a letter and questionnaire to see how we can improve the access. But ongoing problem.

19-09-2006, 04:47 PM
We write after the second DNA. If the patient does not attend a further appt within the next 12 months we issue a final warning, after which Practitioner Services is instructed to remove the patient from our list if the problem persists. We have a JAYEX sign in our waiting area and monthly stats are published on it in an attempt to increase awareness of the problem.

20-09-2006, 12:08 PM
Our software in Scotland (GPass) automatically flags patients who DNA more than 3 times in 12 months (this can be altered by the PM to suit the practice) Our policy is to deny appointments to persistant offenders - we have an open access surgery every morning.