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At the heart of general practice since 1960

The DNA: the last true perk of primary care

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Charge patients for DNAs? As in, actually penalise patients financially for not turning up to my surgery? Are these people crazy?

These people, in case you missed it, are the members of a think-tank which recently published a study on the future funding of healthcare

Come on, be honest. Hands up all those GP readers who really do get narked by patients who DNA as opposed to think they should make a show of appearing to be narked by patients who DNA? Exactly. After all, we GPs work in a uniquely freebie-free zone. Gone are the days of the lavish pharma-sponsored curry followed by welcome samples of a GORD-busting PPI. We don’t get so much as a free pen these days. There’s not even any point in nicking paper-clips or post it notes given that we pay for them in the first place.

So the DNA is just about the only true perk of primary care. I cannot help but feel unfairly treated if I have a surgery with no DNAs at all. One I view as my right. Two a bonus. And three a caffeinated gift from the gods of general practice. The only reason I don’t actually book patients a follow-up appointment and then pay them not to attend is because I’ve only just thought of it as I wrote that last sentence.

There is, however, a charge I would like to apply to some patients. It involves those who use ‘chronic disease reviews’ as an excuse to present multiple other problems. Oh, and 20,000 volts. 

Readers' comments (16)

  • We all know DNAs are an absolute joy so why do we whinge about them and post notices in the waiting room. Well, I would if I was paying a sessional doctor or nurse to have an unauthorised coffee break I suppose, but as a sessional GP I find that extra 10 mins utter bliss. Why do the last people on your list always insist on turning up when you are ready for home?

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  • I'm a bit conflicted about this.As someone helping to run a practice I get annoyed with DNAs because they waste appointments, but as a doctor doing a surgery I am often very grateful for them. But the real point is that fining patients who DNA would be totally unworkable. Who will do the chasing of payments? How much staff time will it take? What if people refuse - do we refuse to treat them? People either DNA because they genuinely forgot or got mixed up, or are habitual offenders because they have chaotic lives and problems with more than just keeping GP appointments. Do we really want to add to these people's already considerable life burdens by chasing them for money ? I think we should accept DNAs just as we accept all the other imperfections of life and continue to moan about them or be grateful for them depending on which hat we happen to be wearing at the time.

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  • Ohh, first time I disagreed with Dr C!

    Yes they are a bliss but I actually put in scheduled "catch up slots" where I have no patients booked in. To make it fair to my partners, I keep the number of bookable appointments same so my surgery should be 20 min longer then theirs - except it's not any longer, we finish at same time as they often run about 20min late :)

    I'd far prefer having patients coming on time and have no DNAs, than to find my self putting extra appointments to accommodate patients that's request an urgent appointment come end of the day. But that might just be me.

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  • andrew Field

    Love 'em - hapless and hopeless 16-25 yr olds making morning appointments, ne'er do wells failing to appear on sunny afternoons and overweight dole bludgers when the weather's bad. All part of the thankless task

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  • Hadrian Moss

    It's a great relief when you return from annual leave and notice the usual suspects booked into your first surgery. There is no way they will remember that appointment they booked so far in advance!

    At last a breathing space to catch up in, unless some bright spark suggests we start SMS messaging patients to remind them about their appointments.

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  • As a salaried GP - yes I loved DNA's....bring them on.
    As a partner - no, because if we had a zero DNA rates, I could dispense with one whole time salaried GP and one whole time nurse...you can work out the maths for yourself as to how much DNAs cost me.

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  • Hadrian, you do know systmone has inbuilt SMS reminder function, free of charge to send if you have NHS mail account.

    I'm afraid your days of enjoying DNAs are numbered :)

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  • There are basically three types of patient:
    1) The ones who don't book appointments and don't come in
    2) The ones who do book appointments but don't come in
    3) The ones who do book appointments and do come in.
    By far the most troublesome group are the third, followed by the second; the first group being the best.

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  • There is a 4th group - those who don't book appointments but come in anyway expecting Walk-in Centre type service for "emergency" problems like ear wax etc, Then, "while they're here"...

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  • There is a fifth group -those who DNA, but book and come for urgent sick note.

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Have your say

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder