Missed Appointments (DNA)

Why this policy exists

Every missed appointment is time that could have been offered to another patient. This policy helps us use appointments fairly while recognising that there may be genuine reasons why people sometimes find it difficult to attend.

What is a DNA?

A Did Not Attend (DNA) occurs when a patient does not attend a booked appointment and does not contact the surgery beforehand to cancel or rearrange it. This applies to appointments with any member of the clinical team, including face-to-face and telephone appointments.

What happens if I miss appointments?

We use a staged approach over a rolling 12-month period:

First missed appointment

• We record the DNA on your medical record.
• You will receive a reminder text message explaining the importance of cancelling appointments you cannot attend.

Second missed appointment

• We record the DNA.
• You will receive a reminder and a letter explaining the policy.
• We will invite you to let us know if there is anything making it difficult for you to attend appointments.

Third missed appointment

• We record the DNA.
• You will receive a final warning letter.
• Before any further routine (non-urgent) appointment can be booked, you will be asked to speak with the Practice Manager or Deputy Practice Manager to discuss the reasons for the missed appointments and any support you may need.
• Access to urgent or same-day care is not affected.

Will I still be able to get urgent care?

Yes. This policy only affects routine pre-bookable appointments. If you have an urgent health problem, you will still be assessed and treated appropriately. Necessary treatment will never be delayed because of this policy.

Support for patients who may find attendance difficult

We understand that missed appointments can sometimes be related to health, disability, caring responsibilities, language barriers, transport difficulties, safeguarding concerns, or other personal circumstances.

Before any escalation, we will consider whether additional support or reasonable adjustments may help, such as:

• Accessible or translated communications
• Alternative appointment formats (for example, telephone appointments)
• Additional support to help patients attend appointments

Children and vulnerable adults who miss appointments are managed through safeguarding processes rather than the warning system.

Could I be removed from the practice list?

Removal from the practice list is not automatic and is only considered as a last resort after:

• Repeated missed appointments,
• A review by a GP,
• Consideration of any vulnerabilities or support needs,
• Reasonable efforts to help improve attendance.

Any decision would follow NHS regulations and local procedures.

How can I help?

If you cannot attend an appointment, please let us know as soon as possible so that we can offer the appointment to another patient. If there is anything making it difficult for you to attend, please tell us—we will do our best to help.