About this action

Missed appointments and disengagement from care should trigger curiosity, not blame. Missingness is defined as the 'repeated tendency not to take up offers of care such that it has a negative impact on the person and their life chances'. Research shows patients missing more than two GP appointments per year have significantly higher premature death rates and are more likely to have multimorbidity, especially mental health conditions. 'Missingness' shifts focus from blaming patients for DNAs to understanding why some people repeatedly disengage from care and how healthcare systems need to adapt. Approaches to implementation: - Identify patients with repeated DNAs across primary and secondary care, not just GP appointments - Analyse patterns of missed appointments alongside patient demographics, conditions, and social factors - Make sensitive and empathetic contact with patients to understand their specific barriers, avoiding judgement - Map common themes including transport, trauma, treatment burden, and experiences of discrimination - Develop tailored responses based on actual barriers rather than assumptions about 'non-compliance' Key benefits: Transforms DNAs from administrative problems into opportunities for addressing health inequalities, prevents premature mortality in vulnerable groups, and demonstrates that healthcare systems can adapt to meet all patients' needs effectively.