DNA - FOI Response Register

1. What is the volume of DNA (do not attends) for fiscals 21/22; 22/23; 23/34

With regards to missed primary care appointments then in accordance with FOISA s 17(1), NHS Shetland confirms that it does not hold the information requested.

Figures provided are for the number of did not attend outpatient and inpatient appointments.

2. What is the financial (£’s) impact per fiscal to the Board?

Did not Attend In-patient or Day Case:

Health Board unique cost incurred for an individual who did not attend (DNA) is not routinely calculated. The NHS Scotland published cost data calculation is based upon in-patient stay or day case average cost. This only includes those who attended.

If an individual is a DNA the Board will save on marginal costs that may be avoided but these are minimal. These primary being food, laundry and some other domestic costs that are not routinely calculated at an individual patient level.

Other costs are fixed, e.g. non-domestic rates, and not directly affected by patient activity and staff establishment in the ward or theatre is unlikely to have been different due to patient attending or not.

The primary issue with a DNA is the opportunity cost incurred if that prevents a different patient being able to access their elective treatment.

Did not Attend Out-patient:

Health Board unique cost incurred for an individual who did not attend (DNA) is not routinely calculated. The NHS Scotland published cost data calculation is based upon average cost for those who attended.

If an individual is a DNA the Board will save on marginal costs that may be avoided but these are minimal. These though are not routinely calculated at an individual patient level.

Other costs are fixed, e.g. non-domestic rates, and not directly affected by patient activity and staff establishment is unlikely to have been different due to patient attending or not.

The primary issue with a DNA is the opportunity cost incurred if that prevents a different patient being able to access their elective treatment.

3. What is the individual cost of a DNA for general appointments and for the likes of MRI scans?

As above

4. Who has responsibility in the Board for reducing DNAs? Please supply their name, position, telephone number and email address

Prof. Kathleen Carolan – Director of Nursing and Acute Services kathleen.carolan@nhs.scot

Jo Robinson – Director of Community Health and Social Care jo.robinson9@nhs.scot

5. What particular ethnic, religious, native language, level of education (especially literacy), age, gender or particular social groups that are more likely to DNA than others?

In accordance with FOISA s 17(1), NHS Shetland confirms that it does not hold the information requested.

6. What are the main reasons for DNA's and at what point in the process do DNAs trigger?

In accordance with FOISA s 17(1), NHS Shetland confirms that it does not hold the information requested.

7. What identified links are there between waiting times and DNA's?

In accordance with FOISA s 17(1), NHS Shetland confirms that it does not hold the information requested.

8. What projects are currently underway to reduce DNA's?

See below

9. What are your current targets for DNA reduction and are you achieving these?

Our aim is to ensure DNA rates overall are around or below the national average.

In the hospital, we have patient focussed booking and patient initiated follow up in some speciality areas and they are in place to support patient choice, which in turn helps to reduce DNA/CAN of planned appointments.

In the GP Practices, we have a text reminder system, which allows us to send patients a reminder of their appointment, 24 hours in advance, and they can then cancel the appointment by reply if they no longer wish to attend.