The role of digital in NHS England’s letter on reducing ‘did not attend’ rate

NHS England has written a letter to integrated care boards and trust chief executives, highlighting the role of digital to reduce did not attends (DNAs).

The letter highlights that “outpatient care should not be one size fits all” and references successful projects from Royal Cornwall Hospital, North Lincolnshire and Guys and St Thomas’.

It notes that providers should look at a combination of factors around patient characteristics and the healthcare settings when trying to identify reasons for DNAs.

The document states: “Digital solutions such as patient portals are a key enabler for reducing DNAs by providing a route for accessing and sharing patient information electronically, freeing up clinical and administrative time, enabling patient education and encouraging patients to be active participants in their care.”

It suggests that providers should use appointment reminders through SMS, and “offer patients an easy option to cancel and rearrange appointments if they need to.” The letter also recommends offering other methods to cancel “such as via a patient portal or two-way messaging service”, and suggests that providers can look to local care co-ordinators to support with this.

“Continue to offer remote consultations where appropriate and the use of patient portals with appointment reminder and booking functionality, which can give patients more control over booking and cancellations,” it advises. In addition: “Work on digital enablers to review and overcome barriers.”

The letter highlights the impact that digital literacy can have on DNAs. It suggests that another solution to address the number of DNAs is to assess the levels of digital literacy within the organisation and examine how it might be affecting the rates.

It also highlights a risk when removing other forms of access in cancelling an appointment and implementing new digital process instead, such as only being able to cancel appointments through a link in a text which requires the patient to own a mobile phone.

It notes the importance of building in options to capture patients’ preferred means of communication, appointment times and appointment types.

To assist in tackling digital exclusion, the letter raises the need to “ensure that digital access and literacy is taken into account before implementation and that a variety of access is available”, and also to ensure that “digital information is accessible, available in other languages and formats.”

To read the letter in full, please click here.