If the referrals you manage on e-Referral Service are booked into one, or more, directly bookable service then the service(s) are linked to a patient administration system (PAS) or another provider booking system.
When a patient does not attend an appointment, your organisation will outcome the referral as Did Not Attend (DNA) in the PAS. This sends a message to the e-Referral service and the referral will appear on the Appointments for Booking worklist, marked as DNA.
Like all referrals these should be managed appropriately, or they will fill up your worklists. It is advised to look at the history of a DNA before you action it and to know what your local Patient Access Policy is around patient’s who DNA their appointment.
The two main outcomes for a DNA are either to rebook an appointment for the patient, or directly advise their referrer of the DNA.
You can do this in one of the following ways:
Rebook the appointment
You might rebook an appointment for the patient if they are considered “vulnerable” or if it fits with your patient access policy.
To rebook an appointment:
select the UBRN for the patient
choose the Record DNA option from the Actions dropdown
in the Record DNA screen complete the mandatory fields
these are Contact Attempt, DNA Reason (if not already completed) and Rebook
in the Appointment screen, select a new appointment for the patient The patient should always be involved in the appointment booking
complete any subsequent screens and select Save
Print an appointment confirmation letter in the usual way that you would for a patient
Advise the patient's referrer of the DNA
You might want to use this option to let a referrer know that the patient has not attended their appointment. Please refer to your local patient access policy to understand when to use this option.
To advise a referrer:
Click on the UBRN
From the Actions picklist, select Record DNA
In the Record DNA screen complete the mandatory fields.
These are Contact Attempt, DNA Reason (if not already completed), Send for Referrer Follow Up
Complete the screens that follow and Save
The UBRN is removed from the Appointments for Booking worklist and will appear on the Referrer Action Required worklist at the originating referring organisation.
This does not close the referral but informs the patient’s referrer that they have DNA’d. This can be especially useful for vulnerable patients. The patients referring organisation can rebook an appointment, if necessary, when you use this option.
The other options available for DNA’d referrals are:
No Further Appointment this option removes the referral from the worklist and may be the option used most by your organisation
Contact the Patient again after X days the UBRN is removed from the worklist and will reappear in X days time (on the Appointment for Booking worklist), so will still need processing.
To process DNA’s using these options:
complete the mandatory fields and select an appropriate Outcome reason
Save and complete subsequent screens.
There is an optional Additional Comments textbox which will allow free text to be added. This is especially useful if you have any contact with the patient as you can record extra information about why they did not attend their appointment.
This diagram shows how a referral is processed for each of the possible Outcome options: