Reducing DNAs toolkit for London now published on NHS Futures

Dear Colleagues,

As part of the London Learning Improvement Network Outpatient Programme, a new practical toolkit, Reducing DNAs Toolkit for London, to help reduce missed outpatient appointments in London, developed in conjunction with clinicians and operational managers, is now available to download on NHS Futures: Read about it on our LinkedIn page.

The toolkit helps trusts to understand why patients miss their outpatient appointments and how to implement effective, sustainable strategies to reduce them. It brings together evidence, research, and practical techniques trusts can use, and provides a roadmap to help identify gaps in operational delivery and guide your choice of intervention:

• Use the toolkit’s self-assessment tool to identify gaps and tailor interventions to your patient population
• Review current processes and where possible adopt best practices such as two-way messaging and easy cancellation options
• Using data insights and predictor tools, identify patients most likely to miss appointments and offer tailored solutions
• Partner with primary care and community organisations to address barriers like travel costs, getting time off work and digital exclusion.

By reducing DNAs, we can free up thousands of appointments and shorten waiting times for patients who need care most and is one of the fastest ways to improve throughput and meet referral to treatment time targets – just a 1% reduction in DNAs could create over 1,000 extra appointments every month.  

The toolkit will remain a live document, and we encourage colleagues to share their experiences of using the toolkit and the interventions, so it can be updated in real time.  Please let us know if you would like to be an early adopter of the toolkit, and we will work with you to design the best interventions to tackle the issues specific to your site, specialty, or department.

Please do share the toolkit widely with your colleagues and encourage them to start using it. A comms toolkit and materials have been produced to help you to promote the DNA toolkit through your networks and via your channels. We’ll be sharing these with your comms teams as well and asking them to help promote the toolkit to staff and encourage uptake, but please do link in with them too, to help support you in this.

Please contact england.londonelectiveimprovement@nhs.net with any queries, feedback or case studies you would like to share.

Best regards,

London Elective Improvement Team

NHS England – London