Non-attendance at psychological therapy appointments

Objective: Research demonstrates that non-attendance at healthcare appointments is a waste of scarce resources; leading to reduced productivity, increased costs, disadvantaged patients through increased waiting times, and demoralised staff. This study investigated non-attendance and implemented interventions to improve practice.
Method: A mixed methods service audit took place in a primary care psychological therapies service. Existing service guidelines and reporting systems were reviewed. A cross-sectional design was used to compare a year’s cohort of completers of cognitive behavioural therapy (N=140) and drop-outs (N=61).
Results: Findings suggested contrasting guidelines and clinically inaccurate reporting systems. The overall service DNA (Did Not Attend) rate was 8.9%; well below rates suggested in the literature. The drop-out rate from cognitive behavioural therapy (CBT) was 17%. The most influential factor associated with CBT drop-out was the level of depression. The level of anxiety, risk ratings and deprivation scores were also different between completers and drop-outs. The main reasons given for non-attendance were forgetting, being too unwell to attend, having other priorities, or dissatisfaction with the service; again these findings were consistent with prior research.
Conclusions: A range of recommendations for practice are made, many of which were implemented with an associated reduction in the DNA rate.