C. E. Green, Occupational Health Department, County Durham and Darlington Foundation Trust, Bishop Auckland Hospital

Background

DNAs are a serious problem for the NHS. They lead to a waste of clinical/administrative resources, cause considerable cost, and reduce available appointments.

Aims

Since the start of the pandemic most of the appointments in our department became phone appointments. This audit aimed to look at our phone DNA rate in this new way of working.

Methods

Within the Occupational Health department a working group was established to look at our DNA rate. We considered the process already in place to book a manager referral appointment, and considered each step. After defining what our current practice was, we then looked to see where or why our DNAs were occurring.

Results

Over a 6 month period there were 113 missed appointments, out of a total of 1318 manager referral appointments (nearly 9% of appointments).

The time lost (admin and clinical) due to missed appointments was 142 hours. Overall this lead to a cost of £5,798.  (£11,596 annually). We considered all the reasons for DNAs occurring.

Several interventions were put in place to counter DNAs from occurring.

Conclusions

By having a diverse team we were each able to identify many different steps in the process which might increase the DNA rate.

We implemented changes to reduce the DNA rate. Reducing the number of DNA appointments will: reduce costs; improve service efficiency; enable more effective appointment booking; reduce mismatch between demand and capacity; and increase productivity.