Benchill Medical Practice
Patient DNA Policy
Overview
WHAT HAPPENS WHEN PATIENTS DNA – DO NOT ARRIVE?
They MISS AN APPOINTMENT
Background
Most of our Patients know it can sometimes be difficult to get a routine appointment
with a GP or Nurse. In the course of events where demand is unpredictable, that
cannot easily be remedied.
One thing that makes this more difficult to overcome is the problem of missed routine
appointments – DNAs.
Where Patients have been declined routine appointments because the consultations
are fully booked, it is at best disappointing when one of those booked appointments
does not turn up and has not contacted the Practice to cancel the appointment so
that it can be released for others or telephones so late as to make it impossible to
allocate to another Patient.
In 2014, the practice offered 57,354 GP/Nurse appointments. 6119 of these
appointments, were not attended or cancelled and were therefore counted as
DNAs
This is the equivalent of 60 full days of missed clinical appointments.
The cost in time and money is a burden to the National Health Service generally and
the Practice in particular cannot sustain this.
Remember that your DNA is another Patient’s denied appointment.
There is great pressure on appointment availability. National policy is to encourage
patients to expect to be seen within 48 hours, or on the same day for more urgent
problems.
Aim
As a practice we would like to reduce the rate of DNAs, by the use of education, a
certain amount of pressure, and by considering the removal of those who
persistently waste our time.
Objectives
 To free up appointments for those who genuinely need them
 To reduce the waste of clinical time
 To reduce the pressure on all staff in being able to offer prompt appointments
KEEP IT OR CANCEL IT! - SOMEONE ELSE NEEDS THE APPOINTMENT!
HOW TO AVOID BECOMING A DNA
If you cannot attend or no longer need an appointment, please ring us in advance.
Mistakes do happen and the Practice understands that appointments can be
forgotten about or overlooked. In such cases, the Practice will take into account the
reason given by Patients.
Preference, of course, is for the Practice to know in advance so we can offer the
appointment(s) to other Patients in need.
SHOULD YOU NEED TO CANCEL, HERE’S HOW:-
A
By telephone – appointments line 0161 493 9101 (we know this can be
busy so to save time, try B or C
B
By text – if we have your mobile number you will receive a text reminder
24hrs prior to your appointment, simply reply cancel to the text you
have received and we will cancel it for you.
C
On our website – www.benchillmedicalpractice.co.uk
(click on the cancel appointment box at the bottom of the home page)
To help us improve the system and make available 3328 appointments this year for
Patients to book routinely, please adhere to our Practice Policy.
KEEP IT OR CANCEL IT! - SOMEONE ELSE NEEDS THE APPOINTMENT!
The 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
that it makes 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.
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.
If a patient fails to attend a pre-booked appointment on more than one occasion in
the last 12 months, an informal warning letter will be sent to the patient, stating that
we are a very busy Practice and it is, therefore, important that patients keep their
appointments with either the doctor or the nurse. The appointment missed could
have been given to other patients if the practice had been informed that the patient
was unable to attend. See Appendix 1 – DNA Letter 1
DNA 2
If the patient fails to attend another appointment, a second letter is then sent to the
patient, stating that we note from our records that the patient has not attended two
of their last appointments despite a previous reminder and that a third missed
appointment, will risk their relationship with the Practice and this could result in
removal from the practice list. See Appendix 2 – DNA Letter 2
DNA 3
Where a third DNA has occurred, the Practice will review the individual case. The
Practice will consider whether consistent failure to adhere to our Practice policy
constitutes a breakdown between the Patient and the GP (where the GP Practice
has given clear instruction on policy and service provision and the Patient has
chosen to disregard this on several occasions in spite of due warning).
The third letter states, Practice policy is to remove patients from the list who
persistently miss appointments and it is, therefore the practice intention to inform
NHS Manchester to remove a patient from the practice list. See Appendix 3 – DNA
Letter 3
APPENDIX 1 -
DNA LETTER 1
Todays date
Title Forename Surname
Patient address house Patient address road
Patient address locality
Patient address post town
Patient post code
Dear Title and surname
We note from our records that you did not attend your recent appointment with the
doctor/nurse.
I need to bring to your attention that the practice now has a policy regarding missed
appointments.
Patient Explanation – Missed Appointments
Due to the number of patients failing to attend for their appointment this may mean that you
may not be able to see the doctor on the day that you wish to.
In an attempt to try and resolve this, the practice has developed the following policy.

If you fail to attend appointments without informing us we will write to you asking if
you could inform the practice if you are unable to attend your appointment.

If you fail to attend on 3 occasions throughout a 12 month period for appointments
you may be removed from the practice list and have to find an alternative GP
practice.
This is a very busy Practice and it is, therefore, important that patients keep their
appointments with either the doctor or the nurse. The appointments you missed could have
been given to other patients if you had let us know you were unable to attend.
If you cannot keep your appointment, please let us know immediately.
Your co-operation would be appreciated.
Yours sincerely
On Behalf of the Doctors
Melanie Potts
Practice Manager
APPENDIX 2 -
DNA LETTER 2
Title Forename Surname
Patient address house Patient address road
Patient address locality
Patient address post town
Patient post code
Todays date
Dear Title and surname
We note from our records that you have not attended your appointment again, despite a
previous reminder.
I need to bring to your attention that the practice now has a policy regarding missed
appointments.
Patient Explanation – Missed Appointments
Due to the number of patients failing to attend for their appointment this may mean that you
may not be able to see the doctor on the day that you wish to.
In an attempt to try and resolve this, the practice has developed the following policy.

If you fail to attend appointments without informing us we will write to you asking if
you could inform the practice if you are unable to attend your appointment.

If you fail to attend on 3 occasions throughout a 12 month period for appointments
you may be removed from the practice list and have to find an alternative GP
practice.
This is a very busy Practice and it is, therefore, important that patients keep their
appointments with either the doctor or the nurse. The appointments you missed could have
been given to other patients if you had let us know you were unable to attend.
Please note that if a further appointment is missed, we shall have no alternative but to
consider your removal from our list of patients.
If you cannot keep your appointment, please let us know immediately.
Your co-operation would be appreciated.
Yours sincerely
On Behalf of the Doctors
Melanie Potts
Practice Manager
APPENDIX 3 -
DNA LETTER 3
Title Forename Surname
Patient address house Patient address road
Patient address locality
Patient address post town
Patient post code
Todays date
Dear Title and surname
We note from our records that you missed a third appointment with the doctor/nurse despite
two letters sent to you previously about not attending appointments.
As you have already been informed, our Practice policy is to remove patients from our list
who persistently miss appointments and it is, therefore our intention to inform the NHS
Manchester to remove you from our list of patients.
It is in your own interest to register with another Practice as soon as possible to the doctors
of your choice and asking to join their list. Should you have any problem finding another
doctor or registering you should contact West Yorkshire Central Services Agency, Brunswick
Court, Bridge Street, Leeds LS2 7RJ, telephone number 0113 2952500.
Yours sincerely
On Behalf of the Doctors
Melanie Potts
Practice Manager