Non-attendance at the Colorectal Clinic: a Prospective Audit

Introduction: Non-attendance in the out-patient department has financial costs for the NHS and clinical implications to the non-attender and those awaiting an appointment. The aim of this audit was to quantify the percentage of non-attenders at colorectal clinics in a UK teaching hospital, assess which factors affected attendance, establish why individuals fail to attend and to implement appropriate change.

Patients And Methods: The number of 'did-not-attend' patients was recorded initially for 686 appointments. Non-attenders were contacted by post or telephone to ask why this was so. The study was then repeated following telephone reminders to 391 patients due to attend clinic. The 'did-not-attend' rates in the two limbs of the completed audit cycle were then compared.

Results: The initial study revealed a 'did-not-attend' rate of 21%, with significantly more males than females failing to attend (males, 28.6%; females, 16.9%; P = 0.001). The 'did-not-attend' rate was not significantly affected by the day of the week, time of appointment or by the weather. There were 51.7% responses to either the postal or telephone questionnaire regarding non-attendance. Of these, 27.7% did not receive an appointment letter or received it after the appointment. Hospital administration problems were cited as accounting for 34.2% of 'did-not-attends'. In the post-intervention limb, 87 patients (22%) replied to the reminder telephone call, of whom 9 (10%) cancelled their appointment and 78 (90%) confirmed that they would attend. The 'did-not-attend' rate fell to 19.7% although this was not a significant reduction.

Conclusions: Telephoning patients before their appointments is labour intensive and did not significantly improve the 'did-not-attend' rate. Although hospital administration errors account for a significant number of the 'did-not-attends', patients also have a responsibility to notify the hospital if they are unable to attend.