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Tuesday 19th June 2018

Doctors should chase DNAs

19th November 2010

Dr Jacqui Phillips, legal adviser with the Medical Defence Union, warns doctors to check no-shows.


The 10m missed GP appointments and 5m missed practice nurse appointments cost the NHS more than £600m a year.

This is inconvenient for practitioners but also means that some patients could be putting their lives at risk. And that raises an ethical dilemma for a doctor.

Should they wait for the patient to make another appointment, or chase them up?

In one case a depressed man made an emergency appointment to see his GP but failed to show up. He was admitted to hospital the next day having taken an overdose.

The practice had taken no action but a complaint was made to the health service ombudsman, which criticised the practice for having no policy for dealing with missed appointments and for not investigating, given the man’s medical history.

But in another case, a woman unsuccessfully took action over a missed smear test appointment because the practice did all it could to encourage her to attend.

While patients have responsibility to ensure they attend, doctors also have a responsibility in certain cases of non-attendance.

A patient’s health, or social problems, can contribute to their failure to attend.

To help avoid such cases, doctors should ensure patients understand the importance of attending appointments and also have a system for identifying patients who fail to attend and a means to deal with them.

Technology, such as text message reminders, may help cut down on missed appointments to a degree but human nature is still a factor which means patients will continue to miss their appointments come what may.


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