1         Policy Statement

Sano Physiotherapy Ltd (hereinafter referred to as the “Company”) are committed to ensuring clinic diaries are utilised effectively and there is fair access to appointments for all patients. This policy defines the company’s stance on failures to attend (usually referred to as “DNA’s” or “Did Not Attend” appointments) and also the Company’s stance on discharging patients that have lost contact with the Company.

The Company only books appointments in conversation with patients, at times and dates that are agreed verbally, either over the phone or in person. The Company also makes reasonable effort to remind patients of the agreed time and date by sending email/SMS confirmations immediately after booking, and email/SMS reminders are sent for every appointment. With these processes in place, it is the patient’s responsibility to attend at the agreed time.

As a commercial business, the Company must utilise its clinicians effectively. Any downtime caused by DNAs is detrimental to our business. This policy therefore sets out how we manage the inevitable occasions where appointments are missed.

2         Purpose

The document provides written policy and guidance for the Company’s staff and patients so that, where there is a break in continuity caused by loss of contact or failure to attend appointments, each case is processed fairly, consistently and transparently.

3         Scope

This policy applies to all of the Company’s in-clinic services.

4         Definitions

• “DNA” means Did Not Attend, which is often used in place of failure to attend. The Company defines a DNA as any appointment to which the patient does not attend, attends more than half-way through the scheduled appointment time, or gives less than 24 hours’ notice to cancel.
• “No Contact Event” means an event which caused discontinuity in the patient’s journey/care episode. This can be the point in time that a patient was last in contact with the Company but a further event was not scheduled, meaning the care episode stalled, or a point in the patient journey/care episode where we would have expected contact, but non-occurred (such as a DNA or cancelled appointment where the appointment was not re-arranged)

5         DNAs

The Company operates a “2-strikes” policy for referred patients. This means that all patients are allowed the first DNA without immediate consequence, we will rebook and continue the care episode without penalty (although a penalty may be imposed by the referring customer, such as an admin charge to the patient). This is in recognition that patients are people, and people sometimes forget about appointments.

Following the first DNA, the patient should be advised of the consequences of failing to attend for a second time. This is not an absolute, however, and if the patient is not advised of the consequences, this is not recourse to continue treatment beyond the second DNA.

If the patient DNAs a second appointment the file will be closed and discharged back to the referring customer.

5.1                Exceptions and Leniency

The Company accepts that there are some instances where a failure to attend is a genuine, unavoidable situation/ ‘Act of God’ out of control of the patient, or that discharging a patient following a second DNA is a not in the best interests of the patient or the Company.

Under these, or similarly significant and unavoidable circumstances, the company shall use its discretion in the application of the “2-strikes” policy and treatment may continue. In all circumstances treatment shall be terminated if a third DNA occurs.   

5.2                Self-Funded Patient DNAs

Where the client is self-funding, they will reasonably be expected to pay for DNA’s as unused clinician time caused by their error. However, in the spirit of ongoing patient care and relationship building, if a patient has a good attendance record and wishes to re-book the missed appointment, payment may be written-off to maintain a good relationship. If the following appointment is also DNA’d, however, both appointments will be charged in full.

5.3                Customer Agreement To Pay for All Missed Sessions

Some of the Company’s referring customers may ask for us to continue seeing a patient beyond a second DNA. This may occur if a case is particularly serious or sensitive and continuation of care is essential. Under these circumstances the Company will agree to continue booking appointments if the referring customer agrees in writing to pay for all missed appointments going forwards. With this agreement in place, there is theoretically no limit on the number of DNAs a patient may have, and a case will remain open until all authorised sessions are used.

This should be done sparingly, however, as clinics could ultimately be left empty while other patients wait for appointments.  

6         No Contact

The Company is committed to maintaining accurate and up-to-date records and ensuring its customers are kept up-to-date with referred patient’s care episodes. Therefore, where we have had no contact from a patient for 30 days the patient’s file will be closed and the case will be discharged.

Examples of this are:

• where we have not been successful in contacting a referred patient for 30 days from the date of referral,
• where there has been a DNA followed by 30 days of no contact,
• where there has been a cancelled appointment followed by 30 days of no contact,

The Company will make reasonable effort to contact the patient in the 30-day period following the no contact event.

The Company’s managers may use their discretion and extend the 30 day period if they feel that reasonable effort has not been made or there are mitigating circumstances.

For clarity, closing a case and discharging the patient involves invoicing for all sessions carried out and submitting any required reports to the customer and marking the file as inactive on our system. These actions will be completed as soon as possible after the 30-day period elapses.

If a patient makes contact following this period, they will have to contact the referring party and ask for their file to be re-opened or re-referred.