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Reduction in 'did not attend' appointments

Forget me not: cutting down on 'did not attend' patient appointments

Back in 2008/09, Portsmouth Hospitals NHS Trust (PHT) was seeing an average of 3,300 ‘did not attend’ (DNA) appointments. This equates to a staggering £27,500 a month in lost income and longer waits.

In 2008, PHT introduced a text messaging service to our healthcare service for particular clinics which received high number of DNAs. The most common reason for not attending appointments was forgetfulness, especially when appointments such as follow-ups were booked well in advance.

So how did we do it?
We began by sending out patient reminders by letter 10 days before appointments. While this was successful, it was very time consuming for the Trust. We then moved to use Healthcare Communications to provide automated texting and interactive voice messaging (IVM) directly to patients phones.  Whilst the text reminder were well received, feedback from patients on the voice messaging service has been reflected in modifications to simplify the process and minimise any need for patient interaction using the key pad.

The results speak for themselves...
In 2008, within just months of implementation, the Trust saw a reduction in overall DNA rates by 38% compared to the previous year. An internal target for clinic utilisation was set at 92%, which the Trust achieved in many specialties. Ongoing monthly savings of around £40k were achieved.

In 2013-2014 we managed to reduce our DNAs to just under 7% across the Trust.

As we are on our journey to become a Foundation Trust, tackling problems such as DNAs is a crucial part of helping us to improve patient experience. You can help us by doing your part too: if you have an appointment at Queen Alexandra Hospital, please let us know if you can attend/not attend on the date originally specified.

Health Minister Simon Burns, said: “I’m pleased that the number of missed appointments in the NHS has gone down in the last year. It is important that people realise that not turning up for their agreed appointments, means other patients care might be delayed and doctors and nurses time could be wasted, costing tax payers money.

“Today we are highlighting the number of missed appointments so people can see the impact this is having on their NHS. Under the NHS Constitution we all have rights to treatment, such as being seen within 18 weeks. Patients often have genuine reasons to miss an appointment, but it can have a big impact on the care we can offer to other patients. It is important that the public understand we have responsibilities too, like not wasting precious NHS resources.

“I’m glad to see that the NHS is increasingly using simple ideas such as texting their patients before an appointment. These could have a dramatic impact and I want to see more hospitals making use of them.”

The NHS Constitution makes clear that patients have the right to access NHS services, but patients have responsibilities too – it is important to keep appointments, or cancel within a reasonable time.  Otherwise, it can jeopardise patients starting treatment within 18 weeks of a referral.

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Last updated - 10 February 2015
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