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‘Very high’ DNA rates caused by IT failures, trust discovers

Published on: 2 Feb 2023

An acute trust has discovered an IT issue which appears to have led to ‘very high’ numbers of patients not turning up for their appointments.

Bedfordshire Hospitals Foundation Trust discovered appointment letters were being lost, and not sent to patients, during intermittent server failures, its board was told yesterday.

The trust’s “did not attend“ rate has been between 10 and 12 per cent over the last year, compared to the national average of 7 per cent, according to its board papers.

The issue relates to patients with appointments booked at Luton and Dunstable Hospital. It is not yet clear how many patients were affected.

The trust is now planning to ensure every patient with an appointment booked this year receives a new appointment letter, and an apology if they did not previously receive one.

Cathy Jones, the trust’s deputy chief executive, said the trust sends appointment letters virtually to a company in Scotland, which prints and sends them by post.

“We have good assurance that every letter that we send to that company goes,” she told the board.

“But what we have identified – because we were continuing to investigate the much higher than expected DNA [did not attend] rates at the Luton site – is the server that sits in between us virtually printing a letter and transmitting to Scotland had been having intermittent failures.

“Some investigation shows that on the days that server was disrupting, we were losing letters.”

Ms Jones said a team was “working hard to rectify the root cause” of the issue and she believed DNA rates were still “very high”.

She added: “I think we recognise, given our current capacity constraints and patient experience, we probably need to go back and do that labour-intensive exercise of rewriting out to everybody and apologise if they haven’t had a letter [and] make sure they are aware they do have an appointment and this is the date and time that should happen.

“I’m waiting for the team to get back to me with a quantification of the size and the impact of that task.”

The board was told the trust does not solely rely on letters, but also increasingly on text reminders.