Did Not Attend

I recently wrote a post about ways to save our health service. One of the issues I spoke about was the problem of patients not turning up for out-patient appointments. I proposed that the high DNA (did not attend) figures in our hospitals were due to a lack of respect for our inefficient health service. The first comment I received in response suggested that the problem was most likely caused by patients not receiving notification of their appointments in time. I now have reason to believe that Ian is absolutely right.


It’s been 5 weeks since I last had an out-patient appointment with my surgeon. I was advised and given a prescription lasting two months. This new treatment failed within a couple of weeks so I was seen by my GP. He mentioned that he’d had a letter from the hospital detailing my treatment and saying that I would be reviewed again in 3 weeks. This was the first I’d heard about any review appointment so I joked with my GP that it was only the stuff of routine dictation and meant nothing. However when I became ill again 10 days later, my GP decided to phone the hospital himself to see if he could get an appointment. He was told that my name was already on the list for the next out-patient clinic in two weeks time (the surgeon was away in the interim) and that I would be notified by post. Again we laughed at the absurdity of a system that forgets to inform the patient.

I’ve still heard nothing and as the appointment is scheduled for tomorrow, I phoned the hospital today to query the appointment. It was confirmed that I was on the list for the morning but no explanation could be given as to why I’d not been notified. The fact is that had I not become ill since I last attended the hospital, I would never have known that an appointment had been made for my return. Through no fault of my own, I would have been registered tomorrow as a ‘DNA’  and my appointment which could have benefited another patient, would have been wasted.

Our health service is being bled to death by administration costs and it seems that patients no longer matter. What ever happened to the concept of patient-centred care?

9 Responses to Did Not Attend

  1. Baino says:

    Steph this is particularly concerning because these days with Client Relationship Management systems, email and enhanced electronic records, there’s no reason why your letter couldn’t have been automatically generated or an email forwarded with just the press of a button. Sadly, in my own experience (mainly with Dad) the onus was squarely put on the patient to check follow up times even if we’d made the appointment ourselves. I always got into the habit of calling regularly to make sure that we were booked in. Just not good enough. Wouldn’t it be nice to be able to post one day about something wonderful in relation to our various health systems!

  2. Baino says:

    Oh on a personal look, I hope the follow up is good news for you.

  3. knipex says:

    Good luck Steph

  4. Annb says:

    A web based text messaging reminder system is cheap, efficient and widely used in other countries. The HSE have refused to implement it even when it was offered to them free of charge. I feel your out patient pain Steph! I could wallpaper my house with Rory’s missed appointments over the last 5 yrs! I hope all is well Steph best of luck today and bring a good book for the wait!

  5. Grannymar says:

    Hope it is all going well for you at the Hosp App today.

    A web based text messaging or email reminder system might be cheap, efficient and widely used in other countries, but in order to use it satisfactorily in Ireland you first need proper countrywide broadband & mobile phone coverage. Then you need to teach the population to use these technologies and not be afraid to open their emails!

  6. Steph says:

    I’m back!

    Baino – I’ve been attending this specialist for so long that I don’t attend for routine check-ups any more. My GP looks after the easy stuff and if/when I run into trouble, I’m seen urgently at the hospital because of my past history. That’s why I laughed when my GP reported that the letter from the hospital said I would be reviewed routinely. The point I was trying to make is that I book my own appointments NOT the hospital and therefore if I’d not become ill since my last hospital appointment, today’s check-up would have been wasted as I was never notified of it.

    Knipex – Thanks! I fought my corner hard!

    Ann – Interestingly, when I went to check-in, they asked me to confirm my mobile number and then asked if I would be happy to receive notification of appointments by text. That’s when I let them know what I think of their postal system! My dentist uses texts as a reminder of appointments, so I don’t see why hospital appointments couldn’t use a similar system.

    Grannymar – I think that texting will become the way of the future for hospital appointments and those who do not use mobile phones for whatever reason, will continue to be notified by post.

    My appointment today was not an easy one. My surgeon is referring me back to the UK but I have asked him to write first to ask what scans etc are required before I go. I had a great bit of luck when I went for a blood test as when I took a ticket for my place in the queue, it looked like I would be waiting for ever. I must have looked very glum as a man approached and gave me another ticket which was about 50 places ahead of my own ticket. It turns out he took two by mistake so was happy to help lessen my wait. When I had been drained of my blood, I repeated the exercise and handed my original ticket on to an old lady who had hobbled in about 20 places after me. You could set up a nice little business there trading tickets to people in a hurry 😉

  7. Annb says:

    I’m so sorry to hear you are facing into more medical intervention. I hope your referral to the UK brings solutions to your problems, and that you have the good fortune to be met by a similarly kind queue jumping ticket fairy. 🙂

  8. Steph says:

    Ann – The hope is that by going back to the specialist unit in the UK for advice, I will able to avoid any more surgical intervention. I’m lucky to be able to see a world-renowned specialist so close to home. The surgeon I attend here specialises in treating complicated cases but he wasn’t afraid to admit today that he needs help from higher up the ranks. I respect him all the more for his honesty.

    My queue jumping ticket fairy gets my vote too!

  9. […] For Action Here’s a follow-up to my recent post  ‘Did Not Attend‘ and the comments it generated. A new study has found there is a high rate of non-attendance […]

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