Reducing DNAs in the NHS by Digitising Pathways

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Missed appointments, also known as “did not attend” appointments (abbreviated DNAs) cost the NHS millions of pounds every year. The introduction and integration of digital health technologies and solutions, and the resulting digitisation of NHS pathways can significantly reduce the incidence and cost of these DNAs. This article will outline why.

Why do DNAs happen?

Some reasons as to why appointments are missed include:

  1. Patients forget they have an appointment
  2. Patients feel they no longer need their appointment.
  3. Patients are no longer able to attend their appointment due to travel issues, or health issues. 
  4. Patients are not able to attend an allocated appointment slot due to it being at an inconvenient time (eg. During work hours they cannot miss). 
  5. Patients cannot afford to travel to their appointment. 
  6. Hospitals do not communicate effectively with a patient. For example, if a hospital forgets to send a notification to the patient of an appointment time change.
  7. Hospitals have issues booking an appointment for a patient. For example, if a hospital fails to find a date/time that works for them or if there are technical issues with the booking system.
  8. Hospitals fail to rearrange appointments or cancel one’s that they need to. 

How much does a DNA cost the NHS?

The NHS has stated that each GP appointment costs on average around £30, and that 1 out of 20 appointments are DNAs (which amounts to around 15 million appointments per year). The amount of time wasted is said to be around 1.2 million GP hours, according to the NHS. Missed specialist appointments can cost the NHS much more in pounds and time. This is clearly a significant amount of time that could be used towards treating/seeing patients who need to be seen. 

What is a digital care pathway?

A digital care pathway, sometimes abbreviated as DCP, uses digital technology in the management and support of a patient throughout their healthcare journey. One benefit of a digital care pathway is that it provides a more indepth, detailed overview of a patient’s health, which means that more personal, streamlined and efficient care can be provided to them. It is also a cost-effective way to monitor and provide care for patients. 

How digitising pathways is reducing DNAs

By digitising pathways, the reasons listed above regarding why DNAs happen can be reduced and minimised. For example, by increasing digital communication, patients can recieve more reminders about their appointments and will be more likely to remember the date/time. With remote monitoring, patients will be less likely to be scheduled for an appointment when they are well, and therefore will not simply skip their appointment due to it not being useful to them. Patients will have more power over when they have appointments, which will make it so that they want to attend their appointments when they are scheduled. 

By introducing more digital means of communication, hospitals will be able to communicate more effectively with patients, so that if they need to change a patient’s appointment time or date, they can have more confidence in a patient attending the right one. These are only some of the ways in which digitising pathways will help to reduce DNAs in the NHS. 

Why are digital care pathways important?

The COVID-19 pandemic caused many processes to turn digital, not only in healthcare but across most industries. However, as individuals were less likely to be seen in person, and appointments and surgeries were cancelled during the pandemic, the need for digital methods of care increased and became extremely important. Although the effects of COVID-19 are less today than they were in the midst of the pandemic, the learnings from the pandemic are clear: digital care is important and necessary. 

What role does Ampersand Health play in helping to digitise pathways?

Ampersand Health has created digital solutions to help clinicians monitor their patients remotely, so that they can intervene when they need to. Our platform allows patients to track their symptoms, access condition-specific digital therapeutics, and communicate with their clinical team. To learn more about our platform and our role in digitising pathways, reach out to us at

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