Travel, work and medical anxiety: The main reasons why millions are missing hospital appointments, costing the NHS £960m a year

• DrDoctor launches the UK’s most comprehensive third-party study into missed hospital appointments
• AI technology has the potential to reduce Did Not Attends (DNAs) by 30%, saving the NHS up to £320 million a year

LONDON, UK, 23rd October 2024 - The most comprehensive study of UK patients has revealed the reasons why people miss hospital appointments, costing the NHS £960 million per year, equivalent to the budget for nearly 26,000 annual nurse salaries*. 

The report - from  DrDoctor, the UK’s leading patient engagement platform (PEP) - comes at a critical time for the NHS as it faces costs of £2.6 million a day, from 46 missed hospital appointments every minute in the UK**. 

The insights from 5,003 UK adults who have missed at least one NHS hospital appointment in the last two years - and were therefore logged as a ‘Did Not Attend’ (DNA) - finds that nearly half (46%) of these patients go on to miss more.

In 2023/24, eight million patients missed a scheduled appointment. Currently, the elective backlog stands at more than seven million patients. 

“The NHS is under a lot of pressure to fix the growing waitlist. Tackling that problem starts with reducing the number of patients being logged as Did Not Attend to prevent the backlog from growing. We’ve conducted the biggest patient survey into DNA patients because by understanding the challenges patients face, we can better apply AI technology in the right areas - which we know reduces the number of hospital appointments 30%”, Tom Whicher, CEO and Founder of DrDoctor said. 

Appointment Anxiety

The data points to a systemic problem. A third (33%) of DNA patients are not making it from the point of referral to their first hospital appointment, in spite of the large majority (93%) admitting they did in fact want to attend their appointment. 

This in part, appears to be due to appointment anxiety. 42% of respondents said that they feel anxious in the lead up to a hospital appointment - making it perhaps less surprising that DNA patients are most likely to miss a hospital appointment over any other type of appointment. In fact, 72% said they would attend a personal training session, compared to just 57% who said they’d make it to their hospital appointment. 

When analysing the biggest drivers of hospital no-shows, travel related challenges (50%) were repeatedly cited - including a referral to a hospital located too far away or requiring multiple modes of transport, right through to patients not being able to afford the bus or train fare.

Workplace commitments and the fear of loss of income (27%), cultural reasons such as fasting or joining community prayers (17%) and being sent the wrong appointment date/time or the appointment time being changed (18%) were also cited as key barriers to attendance.

Tackling the complexity, head on

The study confronts us with a harsh reality. More than half (52%) of DNA patients are aware that missed appointments are costing the NHS money. And more than half (53%) understand it adds to the length of the waitlist. 

However, it’s clear that there isn’t a good option for patients to take control themselves. 29% of patients who DNA tried to rearrange their appointment but were unable to as they couldn’t get through to anyone on the phone and 19% stated that the process is just too complicated.

“We need to do better. If 28% of patients would find it easier to attend their appointment by being able to rearrange it online, and 25% by being able to move their appointment to a more convenient date or time - then that’s a really quick fix to shrinking the waitlist and reducing DNAs”, commented Tom Whicher, CEO and Founder of DrDoctor. This is why we’re rolling out our Smart Centre - a suite of AI driven solutions. Personalised and tailored AI technology will offer trusts a solution that meets their own individual drivers of DNAs, and that builds on the productivity benefits of hybrid healthcare. Our AI products are all built on Microsoft Azure, and trained on existing trust datasets to enhance their day-to-day operating practices”, commented Tom Whicher, CEO and Founder of DrDoctor. 

DrDoctor’s Smart Centre, which offers five distinct AI solutions, including the DNA Predictor, is proven to help hospitals predict which patients are most likely to miss an appointment, reducing the no-show rate by 30%. It will also roll out Clinic Optimiser to  help healthcare providers optimise their clinic scheduling and capacity to ensure appointment slots are utilised efficiently. One hospital - which operated below capacity on 92% of clinic days - was able to see an additional 8,925 patients within just three months of the trial. 

Designed to ensure trusts can reach DNA patients with the support of its AI products, DrDoctor will help healthcare providers transition from traditional patient engagement models to a proactive approach focused on early intervention and prevention.

Jacob West, Managing Director of Health & Life Sciences at Microsoft said, “Reducing the number of missed hospital appointments is important in addressing the NHS backlog. By leveraging AI technology, the key barriers patients face can be identified and tailored solutions that make attending appointments easier and more efficient can be implemented. DrDoctor's AI Smart Centre, built on Microsoft Azure, transforms theoretical innovation into real-world impact, enabling healthcare providers to address Did Not Attends (DNAs) effectively and improve patient outcomes”.