Following on from the recent announcement of progress on Waiting Time Management at Noble’s Hospital, the Department of Health is thanking the public, after a fall in the rate of missed appointment slots for consultant led outpatient clinics at Noble’s Hospital. Missed appointment slots, often referred to as ‘Did Not Attends’ or ‘DNAs’, result in lost capacity, pushing up waiting time for other patients as missed slots have to be rescheduled. Work across the hospital has seen overall outpatient Did Not Attends (DNAs) reduce to an average of 9% representing approximately 8,000 missed appointments during 12 months.
 
A reduction in the rate of DNA occurrences has shown to be sustained from January 2013 to January 2014, which along with other waiting time management initiatives, has seen an overall increase of 4,100 clinic attendances, up 5.4%. The DNA average percentage for new appointments (i.e. non follow-up appointments) with a consultant has reduced to 7.9% in the same period. These percentage rates compare extremely favourably with the UK, where the DNA rate for new appointments is 14.5% and the average overall rate is 14.3%.
 
The creation in January 2014 of an Outpatient Appointments Bureau at Noble’s Hospital as a one stop shop for the public to make, reschedule and cancel appointments, as well as providing an outpatient clinic check-in service for those arriving at Noble’s Hospital, was part of the work to identify ways to reduce the number of patients failing to attend their appointment. This in turn has led to more effective appointment management, allowing cancelled slots to be quickly reallocated by a single team which has an overview of all appointments at the hospital. 
 
The implementation of the ‘opt-in to appointments’ initiative across Noble’s Hospital outpatient clinics, requires patients to opt-in for their appointment following referral, so that they take ownership of their appointment by confirming that they can and will attend, rather than only having to advise if they are unable to attend.
 
Minister for Health, Hon Howard Quayle MHK said: “Whilst the Department recognises that a reduction in the DNA rate is not the only measure of progress in reducing waiting times, this result, along with the other waiting time management work, represents excellent headway in improving capacity, and using resources effectively and efficiently. The willing engagement of the public through opting-in for appointments and using the appointments reception has played a large part in this – thank you. I would ask that all patients who are able to attend their appointments continue to do so.  If they find that they are unable to attend, please let the Appointments Bureau know as soon as possible so that alternative arrangements can be made and then hopefully the slot can be offered to someone else who is waiting.”
 
Outpatient clinic administrative processes have been reviewed, including managing phone calls, the allocation of new and follow-up appointment slots in each clinic session and the implementation of appointment reminders by letter and for selected clinics by text message. All of these factors have increased the attendances at the reduction in the rate of DNAs and missed appointments.
 
The Minister added: “Despite the progress made, I acknowledge that there is always room for improvement to the services we offer and the efficiency of our administrative processes.  These are reviewed regularly and I know that staff at the hospital will continue their work to make further improvements wherever possible.”
 
Bev Critchlow, Director of Nursing, Midwifery and Therapies said: “In reviewing the administrative processes, and by engaging the patient at the beginning with the opt-in initiative, implementing a range of different appointment reminder alerts and operating the Appointments Bureau, the staff and public have all played their part in reducing the rate of missed appointments. Demand for healthcare continues to increase, and with it the need to use resources efficiently and effectively, so may I take this opportunity to say thank you to the public for their help and to all staff who are working hard to improve the out-patient journey.”
 
The Outpatient Appointments Bureau is open between 8:30am – 5:00pm Monday to Thursday and 8:30am – 4:30pm on Fridays, and can be contacted on 650103. At all other times patients can leave a voice message and are requested to leave their name, contact details, date of birth and the reason for their call. All calls are returned the following working day.