Missed appointments are a constant drain on NHS resources, reducing efficiency and costing the NHS an estimated £100 million a year. A recent study conducted by Ashford and St Peter’s Hospitals NHS Trust found that the introduction of Choose and Book significantly cut the number of missed hospital appointments and reduced patient waiting times and related costs to the Trust.

With Choose and Book enabling more choice and certainty over when and where patients will be seen, there is less likelihood of patients not turning up for appointments because the time was inconvenient for them.

Choose and Book reduced DNAs by 32%

Ashford and St Peter’s is a 500 bed acute Trust serving 400,000 patients in West Surrey and South West London. The Trust implemented Choose and Book in January 2005. By the end of May 2007,

43% of all referrals received by the Trust were generated via Choose and Book.

Between April 2006 and January 2007, the Information team at the Trust reviewed the data on the Patient Administration System (PAS) to quantify the benefits Choose and Book has brought to the Trust and to patients. The Trust monitored the rate of missed appointments, also known as ‘Did Not Attends’ (DNAs) across 23 specialties, comparing referrals processed through Choose and Book to referrals received via the traditional method; by post or fax.

The number of patients who missed a new outpatient appointment at the Trust when referred through the traditional paper referral method reached 4,722 or 10%.

However, the DNA rate of appointments missed by patients referred through Choose and Book was much lower at 608 or 7%. This significant difference represents a total DNA reduction rate of 32% and under Payment By Results equates for £40,000 of income that otherwise may have been lost to the Trust.

Patients booked through Choose and Book have their appointment processed and confirmed more quickly by the Trust, which reduces the time they have to wait for their first outpatient appointment. With the old paper referral method patients would have to wait for confirmation through the post, with the risk that letters may get lost or delayed. The Information team carried out a study monitoring the waiting time for patients referred through Choose and Book compared to the standard paper referral process. The findings show an average improvement of one week; a significant saving of time, helping the Trust on their way to meeting the 18-week pathway.

Said Consultant Cardiologist at Ashford and St. Peter’s Hospitals NHS Trust Dr David Fluck: "By eliminating the paper referral process, Choose and Book allows us to review referrals at a greater turnaround. This is a huge improvement because it cuts out the time consuming administration processes of old, ensuring that patients are treated more quickly. We now plan to work on our Directory of Service (DOS) to ensure that GPs understand which tests can be ordered prior to referral, thus saving even more time in the patient’s pathway".

Director of Performance, Information and Facilities at Ashford and St. Peter’s Hospitals NHS Trust Ian MacKenzie said: “This reinforces experiences of other Trusts who are seeing a reduction in DNAs when patients book through Choose and Book, although the scale of the reduction is still partly determined by the booking system being replaced.”