Rising Did Not Attend (DNA) Appointments | A Growing Challenge in the Urgent Care Landscape
Since the onset of COVID-19, 12.6 million of 211 million appointments made were marked as DNA (5.9%). These appointments, which already encroach on valuable clinical time, represent vital resources that many Trusts and Systems cannot afford to expend – with severe negative impacts on NHS wait times, provider costs, and training clinical capacity.
As the NHS works full steam ahead towards the recovery of services and protection of the patients reliant upon them, it is important to explore how DNA Outpatient Activity has changed since the onset of the pandemic and what critical steps are needed to tackle the growing challenge. At a time when NHS and care providers are already struggling at near-maximum capacity, teams on the ground must be given the tools, technology, and data-driven understanding of their local situation needed to deeply examine and restructure their services for the post-COVID onset climate.
As many organisations have limited access to the ground-level data and insights needed for visibility of the core pathways and key targets for improvement, technology and approaches that integrate such data alongside system and national insights, data validation, and predictive outlooks, are critical to supporting ongoing provider recovery strategies. Through work with our partners in identifying and tackling the current and upcoming challenges facing our healthcare system today, analytics generated through RwHealth’s Data Science Platform have identified several early insights around DNA Outpatient Activity – curated to support the NHS and care providers as they refocus their efforts on provider recovery and improvement strategies.
DNA Patterns | Understanding Nationwide and Age-based Variation Across the Population
Under the changing COVID landscape and lasting impacts of halting all non-urgent care by the NHS early in the pandemic, Outpatient activity – including DNA rates – saw a significant drop in an attempt to manage COVID patients in March 2020. However, with the decreasing COVID levels and the gradual return to normal services, DNA rates have since shown an overall rise, the period between April 2020 – March 2021 averaging more than 470,000 missed appointments and the period from April 2021 – February 2022 averaging more than 630,000 missed appointments.
Streamlining the Pathway to Recovery | Understanding Variations Between Treatment Services
Diving deeper into the variation of DNA’s across the entire healthcare landscape, with a more keen focus on the treatment services most heavily impacted by the pandemic, is a critical component in supporting recovery planning as providers work towards identifying the key services within which improvement opportunities exist. Of note, the analysis identified a particular peak in missed appointments within Ophthalmology services both in 20/21 and 21/22, averaging more than 41,000 and 57,000 missed appointments, respectively.
Exploring DNA Activity Between CCG Providers | The Potential Impact of Telemedicine
The Potential Impact of Telemedicine
This general reduction in DNA rates could partly be due to focus upon switching to virtual modes of care and thereby seeing notable reductions in DNA rates. Indeed, this is in-line with proposals made by NHS England earlier this year, suggesting that CCGs make greater use of telemedicine as a means of providing care to a minimum of 25% of total outpatient appointments. Such changes can be seen reflected in current data, wherein more CCGs are now switching to virtual models of care, thereby seeing notable reductions in DNA rates.
While telemedicine services have been important players in supporting healthcare providers and patients, particularly in the COVID-19 environment, it nevertheless holds the potential to increase health disparities further between different deprivation groups. Although telemedicine comes with several advantages, the risk of exacerbating health inequalities that have arisen since the onset of the pandemic makes it critical that policymakers and healthcare providers ensure any solutions utilised to reduce DNA rates do not further feed into this problem.
Predictive insights for Future Planning
With predictions generated at a national level by the RwHealth’s Health Data Science Platform (DSP), our predictions suggest that DNA appointments could reach and even exceed pre-COVID levels by October 2022. With increasing pressures and demand for appointments, our predictive modelling can help healthcare providers in focusing their strategies for recovery and emphasise service improvement or pathway redesigns. Such planning will need to factor not only the impacts of COVID, despite its link as a key player in rising in DNA activity, other internal and external factors that will exist beyond fluctuations in infection rates require careful consideration when looking for ways to reduce the DNA’s.
To this end, the DSP’s ability to generate these deep provider level and national insights is one that has been truly instrumental in our ongoing work to support healthcare partners in light of the challenges brought about by Covid-19. Supporting planning with advanced modelling capabilities and innovative predictive technology is something that we truly believe will be a vital part of strengthening best practices for key at-risk specialties and patient groups – both as the pandemic continues and as we one day return to a world closer to normal.
We welcome you to download our complete report here for a deeper dive into key findings in DNA Outpatient Appointments.
For those of you who wish to explore the opportunities within this form of advanced data analytics further, we welcome you to try out RwHealth’s innovative Data Science Platform and uncover a depth of critical insights. To set up a free trial of the platform, please get in touch at email@example.com