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Outpatient DNA rates ‘double at weekends’

DNA rates at hospital outpatient clinics can be twice as high on Saturdays as on weekdays, shows a new study that undermines the case for seven-day working.

Researchers audited figures for the ENT unit at East and North Hertfordshire NHS Trust unit over 12 months and found that the DNA rate for Saturday clinics was 22.1%, but only 10.9% for week days.

The rates were calculated relating to 4,160 appointments during the week and 1,874 on Saturdays.

The Government has signalled a desire for seven-day services across the NHS, with applications recently invited for a £50m fund for GP practices to trial ‘innovative’ ways of improving access by February.

But the researchers in a paper published in this month’s Bulletin of the Royal College of Surgeons of England,concluded: ‘There is evidence suggesting patients find weekday appointments more convenient and it may therefore be efficient to match appointment provision to times of high attendance. This would allow the service to mould to the needs of the patient population.’

It also states: ‘There are a number of reasons why attendance on Saturdays may be inferior to weekday attendance. These include the timings being less convenient to patients, more difficulties with hospital transport and patients being more likely to forget appointments at weekends.

‘Prior studies have suggested a number of ways to improve patient attendance, including levying small charges for not attending an appointment. While such measures are likely to be highly unpopular it may be that tailoring an institution’s outpatient appointments to convenient times (and times when there is a high level of attendance) may be beneficial and could allow us to match the needs of our patient population.’

Bull Roy Coll Surg Eng 2014,1:28-29