Missed Appointments (DNA) Policy

• Policy Statement

This Practice is committed to ensuring fair and timely access to appointments for all patients. Missed appointments (Did Not Attend – DNA) reduce availability for other patients and place pressure on Practice resources. This policy sets out how missed appointments are recorded, managed, and the actions that may follow.

• Scope

This policy applies to:

• All registered patients
• All face-to-face appointment types (GP, nurse, allied health professional)

• Definition of a Missed Appointment (DNA)

An appointment will be recorded as a Did Not Attend (DNA) if a patient:

• Fails to attend their appointment, or
• Fails to cancel the appointment giving at least one hour’s notice, or
• Arrives 10 minutes or more late for their scheduled appointment time

Patients arriving 10 minutes or more late will not be seen, as the clinician will be unable to safely accommodate the appointment without impacting other patients. This will be recorded as a missed appointment (DNA).

• Recording Missed Appointments

• All missed appointments will be recorded on the patient’s SystmOne record using the following code:
        o Did not attend – Xa1kG
• DNA entries form part of the patient’s permanent medical record.

• Threshold for Removal from the Practice List

• If a patient misses three (3) or more appointments within a rolling 12-month period, they will be removed from the Practice list.
• Removal will be carried out in line with NHS regulations and the patient will be given 30 days’ written notice to register with an alternative GP practice.
• Patients removed under this policy will not be permitted to re-register with the Practice in the future.

• Exceptions and Discretion

The Practice recognises that there may be exceptional circumstances. Missed appointments may be reviewed and discretion applied in cases such as:

• The patient being an in-patient in hospital at the time of the appointment
• A diagnosed severe cognitive impairment (e.g. Alzheimer’s disease or advanced dementia)
• Other exceptional circumstances at the discretion of the Practice

Each case will be considered individually, and decisions will be documented.

• Appointment Reminders

• The Practice operates an appointment reminder service where possible.
• Reminder messages are provided as a courtesy only and must not be relied upon.
• Patients remain responsible for remembering and attending their appointments.
• Patients are encouraged to use personal reminders such as a mobile phone, calendar, or diary.

• Quick and Easy Appointment Cancellation Options

To support patients and reduce missed appointments, the Practice provides several quick cancellation options, allowing patients to cancel without needing to queue on the telephone.

Patients may cancel an appointment by:

• Cancelling online via the Practice’s online services
• Replying to their appointment or triage text message, where this option is available
• Calling the Practice and selecting Option 3 to leave a dedicated cancellation voicemail

Patients are encouraged to use these options as soon as they know they cannot attend, and at least one hour before the appointment time, wherever possible.

Using these options helps free appointments for other patients and prevents the appointment being recorded as a DNA.

• Patient Responsibility for Remembering Appointments and Keeping Contact Details Updated

Patients are responsible for remembering and attending their appointments.

It is also the patient’s responsibility to ensure that their contact details are kept up to date, including:

• A current telephone number
• Preferably a mobile number, to enable receipt of appointment reminders and text communications

Failure to keep contact details updated may result in missed reminders; however, this will not prevent an appointment being recorded as a DNA.

While the Practice offers appointment reminders and multiple cancellation options, these are provided as a courtesy only. Patients should not rely solely on reminders and are expected to take reasonable steps to remember appointments, such as:

• Setting reminders on a mobile phone
• Using a calendar or diary
• Making a note of appointment details at the time of booking

Failure to attend, arriving 10 minutes or more late, or failing to cancel appointments appropriately will result in the appointment being recorded as a DNA in line with this policy.

• Incorrectly Recorded Missed Appointments

• If a patient believes an appointment has been incorrectly recorded as missed, this should be reported to:
o The Patient Liaison Officer, or
o The Practice Manager
• The incident will be investigated and, where appropriate, the Did not attend (Xa1kG) code will be removed from the patient’s record.

• Equality and Reasonable Adjustments

The Practice is committed to equality and will consider reasonable adjustments for patients with disabilities, health conditions, or additional needs. This does not remove the patient’s responsibility to communicate with the Practice if they are unable to attend.

• Communication of the Policy

This policy will be:
• Displayed within the Practice premises
• Available on the Practice website
• Provided to patients on request

• Review

This policy will be reviewed annually or sooner if required by changes in NHS guidance or legislation.