Non- attendance of the patients for the appointment has been a major concern at the National Health Service (NHS) which makes significant wastage of health service resources and increases waiting time for the other patients. Missed appointments known as ‘Did Not Attends’ (DNAs) can cause serious delays in treatment for other patients (NHS news, 2014). [Here need to explain the authenticity of the above statements with the evidence of NHS Audit or Research]. It has been reported that DNA rates in mental health are higher compared to other settings [Justify the statement with evidences and previous research statistics].
Non-attendance of outpatient/community appointments has been a long-standing issue for the NHS and this is also the case at the First Response team were I am currently working. The patients may fail to see a specialist when needed and thereby impacting on the continuity of care, compliance with medication, and engagement with the service. This translates into a financial impact on the service and the professionals’ morale. Clinical evidence suggests that psychiatric patients who miss follow up appointments have a higher chance of being admitted over a 12-month period and there is more likelihood of a negative effect on the condition [What clinical evidences-justification with previous research].
In the pandemic period we have accustomed to dealing with patients through virtual appointment, and we successfully and effectively assessed the patients. The fact that the practice of ‘virtual’ appointments is attracted more presence of the patients which automatically reduced with DNA’s comparing to ‘face to face’ appointments. Of course, the ‘face to face’ appointment must be provided to the patients who actually requested for the same. Before the pandemic we have followed the practice of ‘face to face’ appointments. But in pandemic time we changed it into ‘virtual’ appointments. When we had this ‘face to face’ appointments the DNA rate was more comparing to the pandemic time ‘virtual’ appointments. I have also noticed that some of the patients refused to join virtually as well. In my working experience at First Response Team in both ‘virtual’ and ‘face to face’, I have realised that we can reduce the DNA’s without making any financial burden to the Trust. The simple way of making changes in the initial appointment letter will definitely reduce the DNA percentage. If the letter includes both the options of ‘face to face’ and ‘virtual’ appointment, the patient could opt whether they are interested in ‘face to face’ or ‘virtual’ appointments. This change will not make any extra cost to the Trust and reduce the DNA’s [Justify the above paragraphs with previous research, NHS Audit Materials, DNA statistics before and after the Pandemic].
This study critically evaluating the issues pertaining to non-attendance (DNA) in initial mental health assessments at Community Health and the significance changes may be considered to solve this problem by using ‘face to face’ and ‘virtual’ appointments without burden to the trust funds. This study is also demonstrates the importance of ‘virtual’ and face to face’ appointments based on the 4 pillars of the Advanced Clinical Practice (Clinical Practice, Leadership and Management, Education and Research). Furthermore, this study demonstrates to what extent the ‘virtual’ appointments benefit to the patients and also safeguarding the health service resources. Moreover, the study also critically evaluate the pros and cons of the ‘virtual’ and face to face’ appointments for the patients at the Community Health. The sources must be used from Academic journals and must NOT be older than 2 years.
