DNA Appointments (did not attend)


We all know how scarce hospital and doctors appointments are and what is more frustrating is the number of DNA’s (did not attend) appointments that are wasted day in and day out – week in and week out – amounting to hundreds every year. 

What does your surgery or hospital do to try to keep on top of DNA’s? Do you do anything at all?

Some surgeries and hospitals display in the waiting room the number of DNA’s in the month – and this can be pretty horrifying when you see just how many appointments are wasted.  But it does get the message over to people if they do not want their appointment please cancel it and let someone else have the appointment. But of course the people who did not turn up for their appointments do not see these statistics.

Some hospitals will send out a text message a few days before your appointment to remind you and if you do not want the appointment they ask you to cancel it. A good reminder especially if the appointment was booked some time ago, but this only helpful for those with mobile phones, perhaps not so good for some of the elderly that do not use such technology. 

I have even heard some doctors confessing that they “do not mind” the DNA’s as this gives them time between patients to “catch up”.

One surgery that I worked in decided to be proactive and look at the amount of DNA’s every month – the partners were shocked to find that there were several hours wasted over the month through patients not turning up for their appointments.

So, they decided that if a patient DNA they would write them a polite letter pointing out that they missed an appointment, and would appreciate if the patient could not make a future appointment that they phone and cancel the appointment.

If the patient had a 2nd DNA the doctors would write again, this time telling the patient it was the 2nd time that they had done this, and if they DNA again for a 3rd with without good reason they “may” be asked to leave the practice list. The letter would go on to explain the amount of DNA’s the surgery was experiencing and the fact that patients were experiencing problems booking appointments and this was not being helped by the fact that so many appointments were being wasted by patients not attending.

This seemed to work well. Patients that received the first letter would phone to apologise, some would just ignore it and receive a 2nd letter – but no one actually got as far as getting a 3rd letter so hopefully the exercise did actually do some good.

All was going well until……………………..

I received a call from reception. There was a patient on the telephone wanting to make a complaint. This obviously concerned me as I prided myself on the very few complaints that we had at the surgery and I was obviously concerned.

The receptionists put the caller through.

The lady was pretty angry. She had received a letter from the surgery regarding her not attending an appointment the previous week.

She went on to say she actually took the time to cancel the appointment the day before the actual appointment, she said that she realised that someone else could have had the appointment.

I asked her what day and what time she called and she confirmed it was on the previous Tuesday at 8.30 (one of our busiest times). I asked her if she could remember who she spoke to (this is way why we get Receptionists to give their names) she confirmed the name of the Receptionists she had spoken to.

I apologised for our error and said that I would look into it for her.

I went down to Reception and checked the rota; it confirmed that the Receptionist in question was actually on duty that day and she was actually on the telephones that same morning, which pretty much confirmed that the patient was correct.

I spoke to the Receptionist and she confirmed that she was on the phones that morning, and that it had been a particularly busy morning reception.  She couldn’t remember the call but she also said that it could have very easily happened – someone could have come up to her and her attention was drawn to something else.

If this had happened before (and more than likely it had) the DNA would have just gone by unnoticed – the patient thinking they had cancelled her appointment, the surgery thinking we had yet another DNA.

We spoke about this at our next Receptionists meeting, and the girls all agreed that it could be something that could have got overlooked, something that they all felt that they might have done at some point.

This didn’t cause any problems UNTIL we started monitoring the DNA’s and sending letters out.

So, from then we make sure that any patient that cancelled an appointment that it was done immediately so as not to have a repeat complaint.

You cannot be sending out such letters to patients that had actually taken the time and trouble to phone in and cancel their appointment.

I wrote to the patient apologising and admitting the error was on our part, and ensuring her that we had looked at our procedures and were making every effort in the future that it would not happen again.