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    Access problem

    Understand what gets in the way of attendance.

    Explore booking, communication and access barriers before selecting a change to test.

    Worked planning example. Figures below are illustrative, not verified ALIRA client results. Review the approach with your team before use.

    Test this idea free

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    Current Approach

    • .14% DNA rate, against a national outpatient average of 5.6%
    • .System sends automated SMS reminder
    • .No confirmation required from patient
    • .No rebooking option if situation changed
    • .Blame lands on "patient motivation"

    National DNA rate: 5.6% of outpatient appointments in England, 2024-25. NHS England Digital

    What Works

    • Clearer reminder text with confirmation wording
    • Include rebooking instructions if situation changed
    • Test with 20 patients on one clinic day
    • DNA rate drops to 6% in one week
    • No extra resource required
    One-week test

    How to test this

    Plan

    Draft two SMS reminder versions. Version A: current message. Version B: clearer wording with confirmation and rebooking option.

    Do

    Send Version B to 20 patients booked for next Tuesday clinic. Track responses and show-ups.

    Study

    Compare Tuesday attendance with previous two Tuesdays. Count DNAs. Did the message wording shift the rate?

    Act

    If DNA rate drops, roll out Version B to all clinics. If not, try a different message or timing.

    Community physiotherapy tested this. DNA rate went from 14% to 6%. The change: adding "Please reply YES to confirm" and "Reply CHANGE if you need to reschedule."

    It's not that patients don't care. It's that the system wasn't asking them to confirm they were coming. When you ask clearly, people respond.

    Ready to cut DNAs?

    Test a clearer reminder message this week. See the DNA rate drop in 7 days.

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