Approximately 50 appointments per week are ‘Did Not Attend’ (DNA), i.e. the patient does not turn up for the appointment and does not contact the surgery in advance to cancel/change appointment. The effect of these are:

    • An increase in the waiting time for appointment
    • Frustration for both staff and patient
    • A waste of resource
    • A potential risk to the health of the patient

General Policy

DNAs must be coded onto the clinical system at each non-attendance by clinical and nursing staff.

If a patient fails to attend a pre-booked appointment on more than one occasion in the last 6 months, an informal warning letter will be sent to the patient, advising them that a further occurrence will result in them being asked to attend the surgery to discuss the circumstances and failure to do so may result in them being removed from our list of patients.

If the patient fails to attend another appointment a further letter will be sent to the patient asking them to meet with members of the Practice Management Team (including a GP, if appropriate). The letter will also warn the patient that should they fail to address the issue this may result in their removal from the practice list.

If the patient fails to arrange to meet with the Practice Management Team or fails to attend another appointment, the matter will be discussed with the GP Partners and a majority agreement will be reached as to whether the patient will be removed from the practice list.

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.


Patients with a chronic condition, eg Diabetes, Coronary Heart Disease, are invited to attend for blood tests initially followed by an appointment with the Practice Nurse. Patients who fail to attend for the initial blood test will be contacted to arrange a further appointment. The appointment with the Practice Nurse will be cancelled to allow for bloods to be done prior to review.


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