Did Not Attend (DNA) and Was Not Brought (WNB) Policy

Purpose

This policy outlines how Berkeley Psychiatrists manages situations where a service user does not
attend, or is not brought to, a scheduled appointment under NHS-funded care (including the Right to
Choose (RTC) pathway).

The purpose of this policy is to:

• Ensure patient safety and appropriate follow-up after non-attendance.
• Provide a consistent, transparent approach that safeguards both service users and staff.
• Maintain compliance with NHS Right to Choose contractual requirements and governance standards.
• Support equitable access and minimise barriers to engagement.

Scope

This policy applies to patients that are seen via the NHS Right to Choose scheme. It covers:

• Remote video or telephone consultations.
• Location-based assessments delivered at Berkeley Psychiatrists’ designated clinical premises or partner sites.

It does not apply to community or domiciliary visits, as Berkeley Psychiatrists does not deliver services in these settings.

Definitions

• Did Not Attend (DNA): When an adult service user fails to attend a scheduled appointment, without giving prior notice or reason.
• Was Not Brought (WNB): When a dependent child or vulnerable adult is not brought to their appointment by a parent, carer, or responsible adult, and no notice or reason is provided.
• Unable to Attend (UTA): When the service user provides sufficient notice to cancel or
  reschedule the appointment.
• Right to Choose (RTC): A national NHS pathway allowing patients to select an accredited
  provider for assessment and treatment.

Right to Choose (RTC) Specific Process

For NHS Right to Choose patients:

Fair Offer Requirement

• The service must evidence that an appointment was offered in line with the referral received (e.g. date/time, contact method, and confirmation sent).
• Automated reminders (SMS/email) are sent 24–48 hours before each appointment.

If the Service User DNAs the Assessment

• We will attempt to contact the same day to confirm reason and willingness to rebook.
• If contact is successful and the patient wishes to continue, we will rebook within 10 working days.
• If contact is unsuccessful after two attempts, we will send a written notification explaining the next steps.

Repeat DNA or Lack of Response

• After two consecutive missed assessments or lack of engagement, the case is reviewed by the Associate Medical Director and Registered Manager.
• Decision outcomes:
  
  • Rebook (if contact re-established and engagement likely).
  • Pause (pending response).
  • Discharge back to GP/referrer (with summary of attempts and risk rationale).

Documentation

• All steps must be recorded in the clinical record and audit trail (date/time, method, attempts, and final outcome).
• A discharge summary must be sent to the referring GP and uploaded to the clinical system.

Was Not Brought (WNB) Process

For children, young people, or dependent adults:

• We will record the appointment outcome as Was Not Brought (WNB), not DNA.
• We will contact the parent/carer the same day to establish reason.
• Where there are safeguarding or welfare concerns, we will escalate immediately to the Safeguarding Lead and document the action.
• If concerns persist or non-attendance repeats, we will liaise with the GP, social care, or relevant safeguarding team as appropriate.
• All decisions must prioritise the safety and welfare of the individual, not simply their attendance.