Reducing Missed Appointments

in General Practice

 

The ‘Appointments Plus’ Programme

 Introduction

More than 61,000 GP appointments are wasted every single day across the NHS by patients who fail to attend their appointment or who don’t cancel their appointment in advance.

DNA Insight provides receptionists with tried and trusted Behavioural Science techniques that help patients to remember their appointments or ring to cancel if they can’t make it. These low cost, evidence based techniques, when deployed effectively across a GP’s Practice can reduce DNAs and Missed Appointments by over 30%.

The DNA Challenge

The reasons why patients miss appointments are many and varied.  The largest group is of patients who just forget, whilst other significant sized groups include those who feel better before their appointment and do not feel an obligation to cancel, and those whose condition worsens and they present at A&E. Others cannot take time off work to attend or find transport to the Practice inconvenient or too expensive.

Given such a variety of causes, a twin track approach is needed to minimise the impact on the Practice. The first approach encourages patients to remember their appointments by engaging them effectively and providing them with the psychological cues to register the appointment in their long term memory.

The second approach recognises that there will always be reasons why a patient needs to cancel an appointment. This approach therefore focuses on creating a commitment in the patient to ring the Surgery in good time to cancel, and allow another patient to be given the now vacant appointment slot.

The ‘Appointment Plus’ Programme

The Programme is conducted through the medium of a morning or afternoon Workshop for Receptionists which lasts between 2 -3 hours and is led by an accredited DNA Insight consultant. Typically, Receptionists are brought together from different surgeries in a Locality or CCG for group training.

The optimum number of participants at each Workshop is 10 -15. Whilst this can be increased if desired, it can extend the duration of the Workshop slightly in order to accommodate the necessary role play exercises.

A number of Workshops are normally needed in each Locality area to accommodate those Receptionists who are part time or who need to cover while others attend the Workshop.

The ‘Appointment Plus’ Workshop

 Our approach to reducing Missed Appointments is Outcome based, and we provide 6 months of support following the Workshop to help Practice Managers and Receptionists embed the techniques learnt on the Workshop in the day to day routine of the Practice.

The first part of the Workshop is largely focused on sharing the techniques that can be used to establish a rapport with patients, and create the conditions that will allow the Missed Appointment reduction techniques to be most effective.  Each technique is discussed in turn and examples provided and discussed of how to employ them in reducing Missed Appointments.

The second part is a role-play exercise in which Receptionists take it in turns to play the patient and the Receptionist, using scenarios that practise the techniques in a safe and non-threatening environment.  This enables Receptionists to feel comfortable about engaging patients effectively and significantly increases the likelihood of the Missed Appointment techniques being successful.

The Workshop Syllabus includes the following topics:

  • The reasons and psychology behind why patients miss appointments
  • Which patient groups/demographics are at high risk of missing appointments
  • The twin track solution – remembering appointments and cancelling in good time
  • Introduction to, and examples of the Behavioural Science principles that prove effective in reducing Missed Appointments:
    • Knowing and Liking
    • Social Proof
    • Commitment and Consistency
  • Techniques to engage effectively with patients so that the techniques can be applied successfully
  • How to apply the techniques in different situations:
    • Telephone based booking
    • Face to Face/In-Practice Booking
    • Waiting Room signage
    • Appointment Cards
    • Text Alert messages
  • Scenario based roleplay to practise the techniques
  • A suggested process and timescales for introducing the Programme to the Practice
  • Summary and Questions

Benefits for Practices

The ‘Appointment Plus’ Programme comprises a collection of measures that, when used together can reduce missed appointments by over 30%. This reduces the need for chronic overbooking, reduces unplanned and unproductive GP downtime and reduces appointment waiting times across the Practice.

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