Did Not Attend (DNA) Policy

Purpose 

Nightingale Valley Practice is committed to ensuring that the best possible service is provided to all patients registered with the practice.  

Patient’s non-attendance at a booked appointment adversely impacts on practice staff and its patients in the following manner:  

• DNA patients take the slot of another patient who could have attended. This in turn increases the waiting times for appointments and on telephone call backs (especially the on-call doctor)  
• Time and personnel required to follow up, and re-book DNA patients diverts practice staff from other duties and therefore wastes resources.  

Consistent application of a DNA policy by all practice staff (clinical and non-clinical) plays an important role in encouraging patients to assist in ensuring that clinics are managed as efficiently as possible with minimal DNAs.  

This policy relates to the handling of DNAs and outlines the expectations of the staff and patients in the 
management of missed appointments.

Responsibility

It is the responsibility as the staff of Nightingale Valley Practice to:

• Make every reasonable effort to ensure that the patient is aware of their booked appointment date, time and location. Every effort will be made to communicate effectively considering any learning, hearing or visual disability.
• Exercise discretion on a case-by-case basis to avoid disadvantaging patients in the case of genuine hardship, misunderstandings and unavoidable circumstances e.g sudden family illness

It is the patient’s responsibility to:

• Advise of any change to their contact detail
• Attend their arranged clinic appointment or cancel/re-schedule with reasonable advance notice.

Policy

If a patient does not attend (DNA) an appointment for the first time, then it is recorded in the notes, and no further action is taken at this time.

If a patient DNAs an appointment twice within a 12-month period they will be sent a Nightingale Valley Practice DNA letter explaining the policy and the effect, it has on the practice.

If a patient DNAs an appointment 3 times within a 12-month period i.e no change in behaviour, then a follow up letter will be sent including details of the process we will follow if we see no acceptable improvement in behaviour. If the patient’s behaviour does not improve, they will be invited to meet with the practice manager to explain any difficulties they may have in keeping appointments. The case will be discussed at the partners meeting and if it is felt that no sufficient progress has been made, resulting in breakdown of the doctor/patient relationship, then they will advise the patient that they are to be removed from the list and will need to find an alternative GP. This will be confirmed in writing, either by the practice manager or the doctor responsible for the patient.