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Abstract
Aims
To identify the main factors causing patients to miss appointments in paediatric outpatients.
To identify what clinics can do to minimise these barriers and boost attendance.
To attempt to illuminate any trends in the demographics of those who DNA (did not attend).
Methods Data was collected by randomly surveying families attending paediatric outpatient clinics during the sampling period. More data was collected from neurodevelopmental and neurodisability clinics due to the high DNA rates reported in these departments. As well as collecting demographic data, the questionnaire investigated the frequency of and reasons for previous missed appointments and patients’ ideal appointment times and booking mechanisms.
Results Of the 72 families sampled, 27.8% admitted to having missed an appointment. The main reason given was patient illness, followed jointly by not receiving the appointment letter and forgetting to attend. There was strong support for patient reminders. 31.9% of participants identified inadequate car parking facilities as a major obstacle. When the sample was split into those who DNA and those who have claim to have always attended, some demographic trends were apparent: the children missing appointments tended to live further away and were older. This was independent of the length of time for which they had been attending the clinic. Families who always attended were more likely to describe themselves as British or Irish (57%) compared to those who DNA (42%).
Conclusions Missed appointments are a misuse of resources, costing the NHS an estimated £790 million annually. Some of the major reasons given for missed appointments in this study (forgetting and not getting the appointment letter) could be tackled by the implementation of a reminder system. Improved car parking facilities would remove a significant barrier. Those who DNA were less likely to describe themselves as British or Irish, indicating a worrying failure on the part of the healthcare system to engage certain groups. Therefore, the factors leading to missed appointments in ethnic minorities and the implementation of targeted interventions merit further exploration.