Did Not Attend (DNA)

Background

Most of our patients know it can sometimes be difficult to get a routine appointment with a GP or Nurse. In the course of events where demand is unpredictable, that cannot easily be remedied.

One thing that makes this more difficult to overcome is the problem of missed routine appointments, DNAs.

Where patients have been declined routine appointments because the consultations are fully booked, it is at best disappointing when one of those booked appointments does not turn up and has not contacted the practice to cancel the appointment so that it can be released for others or telephones so late as to make it impossible to allocate to another patient.

Remember that your DNA is other patient’s denied appointment.

Heathbridge Practice’s DNA protocol

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.

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 on the part of the GP (more GP time) will often be required by the hospital department so that the patient can be recalled.

First DNA

Where this is the first occasion the patient may be contacted by the clinician or practice manager. A DNA code will automatically be put recorded in the patient’s notes.

Subsequent DNAs

Where this might be the second or third occasion etc. the clinician will record this in the patient’s notes and alert the practice manager for a warning letter to be sent out.

Warning Letter

The practice manager will send out a warning letter informing the patient of the number of DNA’s they have had in the last twelve months and that removal from the list is highly likely if it continues.

(Removal from the practice list remains solely at the discretion of the partners. This is normally dependent upon medical circumstances.)

If removal from the list has been agreed, a letter will be sent out to the patient informing them of the reasons behind their removal from the practice list.

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.

Please note: If you cannot attend your appointment, you must cancel at least an hour before your appointment so that there is ample time to offer it to somebody else. If the reason is not valid for non-cancellation at least an hour before, the practice will make a decision whether to apply a DNA code to the patient’s records.

Should You Need To Cancel, Here's How: 

By telephone: appointments line 020 8246 4070 (we know this can be busy so to save time, try

By SMS: (by reply only)

If the practice has your most updated mobile number, you will receive a text confirming your appointment details. If you are unable to make this appointment you simply text back CANCEL and this will automatically cancel your appointment. Many patients prefer this method as it is quick and simple. But in order to access this service, the practice must have your most up to date mobile number.

By the NHS App: If you have the NHS app, you can simply log in and cancel any future appointment.

What we as a practice are doing to reduce DNAs

We are reminding our patients what our policy is and we feel that it is important to enforce it robustly. It has been suggested and discussed at practice meetings that Heathbridge practice puts in place a system to improve services for patients.

We are continuously reviewing our emergency appointments and routine appointments availability. Here is what we will endeavour to do to help you not become a DNA:

• We will always print appointment details for patients who make an appointment face to face at our reception desk. Our appointment cards contain our telephone number should patients need to cancel (even at short notice – at least an hour before).
• If you make an appointment over the telephone, we would suggest that patients record/document the date and time in a way that can be easily accessed – in a diary, on a calendar or for the more technically minded on a mobile phone. Our staff are trained to repeat all appointment details and clarify understanding with patients at the time of making the appointment.

Keep It or Cancel It! Someone else needs the appointment