Reduce DNAs And Save £700M Using A Bit Of Simple Psychology

“Our surgery tried out some behavioural methods and found that sometimes all it required was a rewording of posters or asking patients to repeat their appointment date and time.”

In short

The BBC has reported here on a study by the Royal Society of Medicine which employed simple measures taken to reduce missed appointments, the so-called “DNA”s (Did Not Attend) and found some remarkably simple measures to be extremely effective.


The NHS wastes a reputed £700M in costs associated with missed appointments each year and has scratched its collective head about how to reduce this for years. Traditionally the initiatives have been rather “negative”, and indeed patronising, poster campaigns in GP surgeries telling naughty patients that they are costing the NHS a fortune every year. According to the BBC report researchers suggest this therefore tends to normalise the “bad” behaviour by implying that loads of people do it.

On our own pages we have contemplated “telehealth” reminders about impending appointment times, ranging from simple text message reminders through to more sophisticated prompts. Now however a study of 10,000 GP appointments in which different (and rather more simple) techniques have been employed, seems to be offering the possibility of reducing DNAs for very little money.

So what has worked in the study?

Incredibly (or not, when you really think about it), really simple changes of approach seemed to have significant effects. Asking people to write down their own appointment details reduced DNAs by 18%. Asking phone bookers to repeat back the details had a 3.5% positive effect, and combining simple measures like these with a change of “spin” in the GP’s posters from “Look how many DNAs there are” to “Look how many people attended”, showed a 31% improvement.

We say

Isn’t it refreshing to see the approach that to solve a problem one doesn’t always need to spend a fortune on consultants and infrastructure to get there? Just a bit of smart thinking to establish the fundamentals of human behaviour and a refusal to accept that the status quo will always remain and look at the results. Incredible, yet rather depressing that we’re really not very good socially responsible animals sometimes.

I hate to bang the drum for telehealth one more time, but imagine the combined effect of improving attendance and at the same time employing remote monitoring methods to reduce the need to attend a clinic in the first place and one begins to see the potential for a really quite efficient delivery of at least this aspect of healthcare.

Source: BBC News: Health, medlatest staff