Did Not Attend (DNA) Policy

A DNA happens when an appointment is not attended and the Patient has not contacted the Practice in advance to cancel it or where the cancellation is so late as to make it impossible to allocate that time to another Patient who needs treatment.


Where this is the first occasion, a code will be added to the Patient’s medical record and the DNA counted in a monthly search. A letter or text will be sent to the patient advising of the matter, and to contact the surgery if this has been sent in error.


Where this is the second occasion, the Patient will be sent a second letter by the Practice, advised of the missed appointment and asked to make an appointment with the admin team to explain if there were reasonable grounds for the non-attendance on this occasion. They will be informed that they could be at risk of compromising their relationship with the Practice.


Where a third DNA has occurred, the Practice will review the individual case with the Governance manager and partners and a decision will be taken with regards to addressing the Patient’s future ability to pre-book routine appointments. The Practice will consider whether consistent failure to adhere to our Practice policy constitutes a breakdown between the Patient and the GP (where the GP Practice has given clear instruction on policy and service provision and the Patient has chosen to disregard this on several occasions in spite of due warning).

Removing Patients from the Practice List

Potential removals will always be discussed with management and partners. The decision to remove a patient from the list will only happen if a senior partner agrees.

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.

This regulation requires that the patient has been warned that they are at risk of removal. The practice must keep a written record of the removal of any patient from its list including the reason for removal, the circumstances of the removal and the grounds for removal. If the decision is made to remove the patient from the registered list, the practice should write to the patient explaining them of the practice decision and advising them to register with an alternative practice.

Once a decision has been made, Practice Manager will follow Patient Removal Policy, 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.

If you need to cancel or change any appointment, you can:

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