Missed appointments policy (DNA)

Last Updated: Thursday, 03 September 2026

Did not attend (DNA) overview

A Did Not Attend (DNA) occurs when an appointment is not attended, and the Patient has not contacted the Practice in advance to cancel it, or when the cancellation is so late that it is impossible to allocate that time to another Patient who needs treatment.

The Practice will code this DNA, which will prompt a retrospective check of the number of DNAs recorded against that person. Whilst we are primarily concerned with our own appointment observance, we may also consider any hospital appointments where we have been notified that a Patient has failed to attend.

The hospital department will often require a re-referral from the GP (more GP time) so the Patient can be recalled. If this is the first occasion, we will add a code to the Patient’s medical record and count the DNA in a monthly search.

What happens when patients miss appointments?

We realise everyone can make mistakes, so we won’t take action if a single appointment is missed in error. However, a minority of patients miss appointments regularly, and this can significantly impact other patients. 

If a patient misses an urgent appointment booked the same day, or if a patient misses TWO non-urgent appointments in a 12-month period: 

In these instances, we send a letter to the patient explaining the problem with missed appointments and the impact this has on the service we provide to our 11,400 patients.

We list the missed appointment (s) and offer the opportunity to discuss if the patient feels this is incorrect. The letter also insists that, in the future, they call to let us know if they cannot attend a booked appointment. The letter also advises the patient that instead of phoning the surgery, they can cancel an appointment via patient online services or, if they’ve received a reminder text, simply reply with the word “cancel”.

If a patient goes on to miss a further appointment within 6 months of the first letter being sent:

They will receive a letter notifying them that their continued registration at the practice will be reviewed by the GP Partners in their next meeting. Patients are invited to write or telephone to explain any mitigating circumstances, which we will consider.

If there is no improvement and no mitigating circumstances, we will remove the patient from the practice list.