Did Not Attend (DNA) Policy

‘Did Not Attend’ (DNA) is when the patient does not turn up for the appointment and does not contact the surgery in advance to cancel/change appointment. Wasted appointments are a huge problem throughout the NHS. The issue of Did Not Attends (DNAs) is a continued frustration for both patients waiting to get an appointment with their GP or Nurse and for those working in the Practice.

The effect of DNAs is:

  • An increase in the waiting time for appointments
  • Patient needing medical care not being able to see their doctor
  • A waste of resources


What we do to try and help

  • If appointments are booked in person we provide appointment cards which act as a reminder of the appointment and has contact details if the appointment needs to be amended/cancelled
  • If we have a patient’s mobile number we try and remind them of their appointment via text messaging. This is why it is important to let us know if you have changed your mobile telephone number
  • Offer a variety of appointment types including telephone and late evening appointments to allow patients to be able to arrange a suitable time and method to consult their doctor
  • Facilitate amending/cancelling appointments which can be done in person, on the phone, via text message and via online access.


  1. If a patient fails to attend a pre-booked appointment on one occasion they will be sent a text message with an informal warning and sign posted to the practice DNA policy. If a text message is unable to be sent then a letter will be sent instead.
  2. If the patient fails to attend another appointment within a 12 month period, a formal warning letter will be sent reminding them that should they miss another appointment they risk being removed from the practice list.
  3. If the patient fails to attend 3 appointments within a 12 month period, this patients’ details will be brought to the practice clinical meeting where a decision as to whether the patient is removed from the list will be made after reviewing their medical notes

Warning letters are only valid for a period of 12 months; removal based on warning greater than 12 months old will be invalid. In such a scenario only the DNA appointments within a 12 month period may be reviewed to determine which stage of the policy should be applied.

Removing patients from practice list due to DNA’s

This decision can only be made if the patient had met the above criteria and has been discussed at a practice clinical meeting. Removal of a patient from the registered list for repeatedly failing to attend appointments will be in accordance with

The NHS General Medical Service Regulations 2015 (Sch3)(24)(8)(b). This regulation requires that the patient has been warned that they are at risk of removal and that the reasons for removal have been explained to the patient.

If the decision is made to remove the patient from the registered list, the patient will be informed via a letter explaining to them the practice decision and advising them to register with an alternative practice. They will be given four weeks to appeal against the decision should they have any valid extenuating circumstances that they wish highlight resulting in the DNA appointments.

Once a decision has been made, the practice will need to inform NHS England and request the deduction of the patient from the registered list. The patient will be deducted on the eighth day after NHS England has been notified (GMS Reg2015(24)(8)(b)).