Did Not Attend (DNA) Policy


Approximately 90 appointments per month are classified as “Did Not Attend” i.e. the patient did not turn up for the appointment and did not contact the surgery in advance to cancel or change their appointment. The effects of these are:

  • An increase in the waiting time for appointments.
  • Frustration for both staff and patients.
  • A waste of resources.
  • A potential risk to the health of the patient.

General Policy

If a patient fails to attend a pre-booked appointment on more than three occasions in the space of six months, the matter will be discussed at a practice meeting as to the form of action required. If the patient fails to attend further pre-booked appointments the matter will be discussed again at a practice meeting and a majority agreement will be reached as to whether the patient will be removed from the practice list. In this case a formal warning letter will be issued.

Warning letters are valid for a period of 12 months. Removal based on warnings greater than 12 months old will be invalid. In this case, a further formal warning and period of grace will be required.

Screening Appointments

Where a patient with a chronic condition or is otherwise deemed to be “at risk” fails to attend a screening or a recall appointment, there may be an implied duty on the practice to follow up the reason for non-attendance to ensure that the patients’ health is not at risk.

The responsible clinician (usually the doctor or the nurse holding the clinic) will be responsible for initiating action to contact the patient by telephone to determine the reason for the failure to attend, and where possible re-arrange the appointment.

Where a new appointment is arranged, this is to be followed up with a letter of confirmation, and, the day prior to the new appointment date, a further telephone call to the patient is to be made to check that they will attend.

The clinician will have overall responsibility for the individual patient follow up and attendance, although the administration aspects may be delegated.