Unattended appointments – known as DNAs (Did Not Attend) – are a costly and chronic problem for the NHS. At a time when Trusts are trying to address the growing backlog of appointments following the pandemic, it is crucial they take every measure to reduce the number of avoidable missed appointments.

Like many up and down the country, St Helens and Knowsley Teaching Hospitals NHS Trust faced similar challenges, with DNAs accounting for 7% of appointments across all sites. In order to address this, the Trust needed to find a solution that could reduce the number of DNAs through more effective communication without placing further pressure on staff.

Introducing efficienC

To counter the drain of appointments and reduce the costs associated with DNAs, the Trust sought help from RIS supplier Wellbeing Software, who introduced their efficienC appointment management solution to support the radiology department which had a DNA rate of 5-7% increasing to 8-9% in ultrasound.

efficienC is integrated with the Cris patient database to provide automated, secure and accurate patient data for targeted campaigns. To reduce the prevalence of missed appointments, efficienC sends an SMS and requests a text confirmation from the patient seven and three days in advance of their booking. Staff at the hospital are then able to manage the responses from a single dashboard and fill any cancelled slots, maximising the utilisation of available appointments.

The Pilot

The key objective of the pilot was to demonstrate the efficacy of efficienC in reducing Radiology Department appointment Did Not Attend (“DNA”) rates across various modalities.

Hospitals that took part included:

EfficienC went live with the pilot and started sending messages to patients in November 2020. The impact of COVID-19 meant that in-person support and training was made impossible. That meant during go-live, efficienC staff were available remotely to ensure additional training was available on demand. Support was also offered to any questions or queries regarding functionality so they could be answered dynamically.

Delivering results

During the pilot, efficienC sent 3,509 messages with a response rate of 82%. The system resulted in 282 cancelled appointments which may have otherwise been DNAs. When looking across the various DNA reduction measures, there was an average reduction in DNAs of 81% over the pilot term, which demonstrated an ROI of 21 times the EfficienC service cost.

The Radiology Department is now running at a 2% DNA rate week on week.

The high response rate indicates a preference for self-service in terms of appointment rescheduling, which can be expected to improve as the solution becomes more mature. As well as the positive results of the pilot, the efficienC solution is also fully scalable and can be applied across a broader set of specialties across all of outpatients and inpatients.

 “The team at EfficienC have been really supportive during the pilot especially with remote onboarding. We have found the patients to be engaged and open to using the technology and we hope it has had a positive impact on their experience with us.

“With an ever-increasing demand for our service it’s vital that we utilise all our capacity. EfficienC has made a big difference particularly in our ultrasound department which saw DNAs reduce from 8 – 9% to around 5% during the pilot. We expect to see further reductions when we are sending text messages to every patient who has made an appointment with us.”

Quote from St Helens and Knowsley Teaching Hospitals NHS Trust: