Frequently Asked Questions

Non-attendance by patients

What is non-attendance?
This is defined as patients who, having accepted a ?reasonable offer?, cannot attend (CNA) or does not attend (DNA) assuming a reasonable offer of appointment / admission has been made. The patient's reporting waiting time will be adjusted following non-attendance. In addition, 'non-attendance' can also mean cancellation by hospital, however this has no impact on the patient's reported waiting time.

What happens if a patient contacts the service to say that they cannot attend and wish to reschedule?
The details (e.g. date of cancellation and explanatory text) should be recorded, the original date of addition to list remains, the waiting time is reset to zero from the date at which the cancellation is made, and the patient should be made a further reasonable offer. If a patient asks to reschedule an appointment or admission for a 2nd time, advice of the responsible healthcare professional should be sought and unless clinically inappropriate the patient should be removed from the waiting list and returned to GP care.

What happens if the patient fails to attend after agreeing to an appointment/admission?
The DNA details (date and explanatory text) should be recorded on system, the DNA to be confirmed as factually correct (any letter should be sent to patient and copied to GP), advice should be sought from the responsible healthcare professional in order to determine further actions and unless clinically inappropriate the patient should be removed from the waiting list and returned to GP care; if remaining on waiting list, the reason should be recorded and the waiting time reset to zero; the original date of addition to list remains. If appropriate, the patient should be made a further reasonable offer.

What if the patient has a valid reason for not attending?
Correspondence to patients regarding appointment/admission dates should make them aware of the consequences of failing to attend without prior notice. Also, the process of ensuring that offers are reasonable and that the patient has agreed to a date, time and venue that suits them, means that these should minimise the number of patients failing to attend without giving notice.

What should happen when patients 'Could Not Wait'?          
The answer to this is dependent on situation in which the 'Could Not Wait' occurs so local judgement will be required. It is suggested that if the patient is not prepared to wait for a realistic period of time then they should probably be treated as a CNA, if however they have waited for an extensive / lengthy period of time in the clinic and they are unable to wait any longer then this should probably be treated as a 'Cancelled by Service' i.e. it is an issue with the way in which the service is being provided.  This would be recorded under WT16 'Non Attendance Category' there is an code for 'Could Not Attend' and for 'Cancelled by Service'. [Added 20 April 2008]