A waste of time: non-attendance at out-patient clinics in a Scottish NHS Trust

Abstract

The Patient's Charter states that patients have a responsibility to attend out-patient appointments or to notify the hospital if they are unable to do so. Non-attendance without notification has substantial financial costs for the NHS and may have clinical implications to the non-attender and other patients on the waiting list.

Objective: To identify reasons for non-attendance of patients for their first appointment after referral.

Design: A survey by questionnaire of a random sample of non-attenders of an NHS trust.

Setting: Aberdeen Royal Hospitals NHS Trust.

Subjects: Ten per cent of all non-attenders to the Trust out-patient clinics over a twelve month period.

Results: One hundred and fifty five (32%) patients contributed to the survey. Cancellations accounted for 22% (34) of missed appointments with factors relating to illness or treatment, being the most common reason (14; 44%). Patients failing to attend without prior notification stated that hospital administrative problems (75; 57%) and personal administrative problems (31; 23%) were the primary reasons. Clinical speciality, day of the week, the month, availability of a telephone or car, and socioeconomic group were not significantly associated with non-attendance.

Conclusion: The majority of patients show a responsible attitude to attendance at outpatients when appointments were received. Non-attendance was found to be due to a combination of institutional factors (commonly administrative) and patient factors such as forgetting about the appointment.