Background/introduction Reductions in sexual health budgets have occurred across England. There is significant focus on the Public Health Outcomes framework and requirements to deliver improved services for less. Sexual health services are examining ways to be more efficient. In 2015 we set out to examine aspects of inefficiency within our service. We highlighted a high ‘Did Not Attend’ (DNA) rate for Follow up patients as a significant inefficiency. We describe a service review undertaken as part of service improvement plan looking at the reasons and triggers for patients not attending or cancelling their appointments.

Aim(s)/objectives To describe associated factors with not attending appointments when a follow up (FU) appointment has been arranged. To identify solutions to reduce DNA rates to release extra capacity for new appointments.

Methods Focused initial data collection on Doctor follow up stream for November 2015. Aimed to look at whether the following impacted on DNA rate: SMS reminders, Time between booking & appointment and Reason for follow up

Results The overall DNA rate for Doctor Follow up appointments is 23.7%. Median time from appointment made to appointment either attended or not was the same, 18 days. Patients re-attending for Gonorrhoea and chlamydia treatment, Post exposure Prophylaxis FU, Herpes FU and patients with ongoing symptoms attended well. Patients attending for hepatitis B vaccination, window period testing, FU for Pelvic inflammatory disease and Chlamydia Test of cure were significantly more likely to DNA. A survey was conducted to ask patients what were the acceptable means of avoiding DNAs.

Discussion/conclusion A total of 165 appointments were missed in November 2015, equivalent to 10 appointments every day. Introducing additional text reminders, using social influence models to increase patient cancellation, were all likely to reduce DNA rate and increase capacity for new appointments.