A DNA is when a patient Does Not Attend a booked appointment with any member of the team and does not contact the surgery in advance to cancel or change the appintment.

There is huge pressure throughout the NHS on appointment availability. By increasing awareness of this problem and enforcing our policy robustly we would like to reduce the number of DNAs in order to free up appointments for those who need them.

The effects of DNAs are:

• Increased waiting time for appointments
• Increased pressure on staff who are unable to offer prompt appointments
• Potentially a health risk to patients
• Costs the NHS billions of pounds per year

It is the duty of the patient to remember and attend their pre booked appointment. If a patient fails to attend a pre-booked appointment (doctor or nurse) then this is considered to be a missed or DNA appointment. Patients who are offered a telephone appointment and given a time period for the doctor to call them then fail to pick up the call during this appointment is also considered as a DNA. The doctor, however, will try more than once to call you if you fail to pick up the call on the first time of calling. Since you had missed the original call, this would be considered as a DNA.

For face to face appointments, DNA’s are when patients arrive 10 or more minutes later than their appointment time. (See Lateness Policy)

Same day appointments

If the patient is offered a same day or urgent appointment and DNA without reason, this will be taken seriously and would breach our DNA policy. Their attendances may be reviewed by the surgery and the patient may be warned about further attendance.

Same day appointments made via our website

If an appointment has been allocated to the patient via the website then a response and SMS (where appropriate) will be sent to the patient with the appointment details. The patient will be asked to confirm the appointment within an hour of the appointment time. If the appointment is not confirmed, then the reception team will cancel the appointment and offer to another patient.

DNA 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 (less than an hour’s notice) 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.

If a patient has registered their mobile number with the practice and consented to SMS messaging. All pre-booked appointments for Face-to-Face appointments will be sent a text reminder message 24 hours before the appointment. There will be details within the message on how to cancel the 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. We continue to review 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 slips contain information on ‘How to cancel’
• If you make an appointment over the telephone, we suggest that Patients’ record/document the date and time in a way that can be easily accessed. Our staff are trained to repeat all appointment details and clarify understanding with Patients at the time of making the appointment.
• We encourage patients to register their mobile phone with the practice and where patients have agreed, they will receive an SMS message to their mobile phone 24 hours prior to the clinic date reminding them of their attendance.
• We review DNA data monthly and review our processes to support patients to attend their appointments.

DNA 1

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. An SMS will be sent to the patient to make them aware they missed their appointment and giving details of how to cancel for future reference.

DNA 2

Where this is the second occasion, the Patient will be contacted by the Practice via a warning letter advising of the missed appointments. An alert will be added to the Patient record. When the Patient makes a further appointment, they will be advised by the Receptionist that the Practice is aware of their previous DNA’s and asked to confirm their intention to attend their next appointment. The Patient will also be informed that if a further appointment is DNA’d, they could be at risk of compromising their relationship with the Practice.

DNA 3

Where a third DNA has occurred, the Practice/Partners will review the individual case and a decision will be taken with regard to addressing the Patient’s future ability to pre‑book routine appointments and a final warning letter will be issued advising that further non-attendance will result in removal from the practice register.

DNA 4

Where another DNA has occurred, the Practice/Partners will review the individual case and a decision will be taken with regard to the removal of the patient from the practice list. The Practice will consider whether consistent failure to adhere to our Practice policy constitutes a breakdown between the Patient and the GP. A removal letter will be sent to the patient advising them of the removal.