Missed appointments (Did Not Attend or DNAs) still remain a deep-rooted problem for the NHS, with thousands of appointments wasted each year. Of the more than 103 million outpatient appointments booked in 2021/22, approximately 7.6 per cent ended in DNAs, equating to an average of 650,000 missed opportunities per month. At a cost of approximately £120 each to the NHS, this equates to almost £1bn. The financial strain from these missed appointments is profound, costing the NHS dearly in terms of lost revenue and increased pressure on already stretched services.

Reasons why DNAs occur

There are many driving factors leading to DNAs. A patient may have simply forgotten about their appointment, or they may feel better and no longer need a consultation. Life may get in the way on the day of the appointment, a patient might be unaware of an appointment in the first place, or the person can’t get time off work to attend. In most circumstances, a simple reminder or an easy facility to cancel or reschedule could alleviate a potential DNA. Currently, reminders include letters, SMS and phone calls, and have been shown to reduce DNAs by up to 80 per cent. These results can only be improved by making the communications with patients a two-way process, giving patients the ability to acknowledge or confirm an appointment and to make contact easily with the trust should they then need to cancel or reschedule.

Addressing DNAs with technology

Communications Platforms as a Service (CPaaS), like Cisco’s Webex Connect, are at the forefront of tackling this issue by enhancing patient engagement and improving two-way communication efficiency. CPaaS technology allows NHS trusts to send patients personalised appointment reminders, confirmations, and follow-up messages through multiple channels such as WhatsApp, SMS, email and social media. This proactive engagement helps ensure that patients are well-informed and less likely to miss their appointments.

By reminding patients of their appointments and providing easy options for rescheduling or cancelling, CPaaS solutions help minimise the occurrence of DNAs. With fewer missed appointments, clinics can reallocate resources to reduce waiting times and address backlogs, enhancing service delivery and patient care. Furthermore, engaging with patients through their preferred communication channels demonstrates a commitment to patient-centric care, fostering trust and satisfaction.

Empowering the patient

One of the key features of CPaaS is its ability to facilitate two-way communication, empowering patients to confirm, acknowledge, or reschedule their appointments with ease. This interaction not only improves engagement but also streamlines the cancellation process, allowing for better management of clinic schedules.

This approach also plays a crucial role in addressing health inequalities by offering digital engagement options for those who might feel uncomfortable making phone calls or have difficulty visiting clinics in person. By tailoring communications to meet the unique needs of different demographic groups, healthcare providers can ensure more equitable access to services.

Data-driven insights for better healthcare delivery

Two-way communication with patients also plays a crucial role in reducing health inequalities by providing valuable insights into the unique challenges faced by specific demographic groups. Firstly, it allows healthcare trusts to proactively offer services to the public, such as digital engagement for non-English speakers who might not feel comfortable making a phone call. Or allowing someone struggling to get time off work to simply reschedule from their phone.

By analysing communication patterns and engagement levels across different patient populations, healthcare providers can identify disparities in access to care and tailor interventions to address these gaps. This targeted approach ensures that healthcare services are more equitable and accessible to all, regardless of socioeconomic status or geographic location.

By using data analytics and insights provided by CPaaS solutions, trusts can predict demand more accurately. In partnership with companies like Deep Medical, which uses AI to predict DNAs with high accuracy, CPaaS platforms can enhance operational efficiencies and improve overall healthcare outcomes. This foresight enables healthcare providers to optimise appointment scheduling, allocate resources efficiently, and reduce the likelihood of overruns. As a result, clinics operate more smoothly, with fewer delays and disruptions, ultimately enhancing the patient experience and staff satisfaction.

As NHS England continues to tackle the elective care backlog, the integration of CPaaS solutions is proving indispensable. By reducing DNAs and enhancing the patient experience, CPaaS not only supports the NHS’s operational goals but also contributes to a more sustainable healthcare system. NHS trusts can significantly reduce the risk of DNAs occurring in the first place by reminding patients of upcoming appointments and offering convenient options for rescheduling or cancelling. Two-way communication enables patients to confirm their attendance or notify the clinic of any changes, leading to higher appointment attendance rates and fewer wasted slots.

The financial impact of DNAs on healthcare organisations cannot be overstated. Each missed appointment represents lost revenue and strains already stretched resources. By implementing CPaaS solutions, NHS trusts can protect against the DNA happening in the first place, helping to minimise the financial and staff burden, leading to significant cost savings and operational efficiency gains. In turn, valuable capacity within clinics is freed up. With fewer missed appointments, healthcare providers can reallocate resources to clear backlogs and reduce waiting times for patients. This ensures that those in need of care receive timely access to services, improving overall patient satisfaction and outcomes.

Richard Evans is Chief Technology Officer at CINOS