In the case of follow-up consultations or where you have been advised of a clinically significant abnormal result or diagnosis, you have an ethical obligation to attempt to contact no show patients.
Where consultations are based on tests either undertaken or recommended you also have a legal obligation to follow-up on no show appointments to either remind patients to undergo the test or procedure, or to advise the patient of the results.
For non-urgent consults this can be done by letter but contact is preferably made by phone. In all cases the patient should be informed of the reasons for the need to have a follow-up consultation.
No show patients may be reduced through a few simple strategies. Patient contact details should be confirmed at each visit to ensure your practice has the most up to date contact details and attempts to contact a patient by phone or text should be made at different times of the day in case, for example, they have to switch their phone off while working. Patients may benefit from text or email reminders 24 hours prior to their appointment though personal phone calls to confirm appointments have been shown to be more effective than automated ones. All contact attempts should be documented in the patient’s file, this can include the date and time of phone call, the name of the person who called and any message left. Copies of letters sent should also be retained in the patients’ medical record.
As part of a no show appointment policy it can be helpful to have a system of logging and flagging patients who regularly miss appointments. Your practice may also consider cautioning patients who repeatedly miss appointments for no good reason. Doctors who work in private practice are conducting a business and as such may charge a cancellation fee for patients who miss an appointment or who cancel at late notice provided patients have previously been advised – typically through a notice displayed in the practice – that a fee may be charged if they fail to make their appointment.
When creating a no show appointment policy it is important to note that cancellation fees should be fair and reasonable and cannot be imposed if there is an environmental crisis or some other circumstances beyond the control of the patient which prevents them attending.