Published: 06/10/2005 Volume 115 No. 5976 Page 29

Nick Power is outpatient manager at Whipps Cross University Hospital trust.

Whipps Cross Hospital had an overall did-not-attend rate averaging 17 per cent and has been looking at ways to reduce this. Text-based reminders were investigated, but rejected because they were limited to mobile phones. Letters and manual phone calls are expensive and time consuming, so we decided that automated telephone reminders could be the answer.

We ran a three-month pilot with service provider Courtesy Call from December 2004 to the end of February this year in ear, nose and throat, dermatology and orthopaedic departments. During this time we experienced a significant reduction in our DNAs. The overall contact rate for patients hearing their reminder details was 88 per cent.

The message, delivered seven days before the appointment, gave the option for the patient to cancel or confirm their attendance - 3 per cent cancelled, which enabled clinics to re-allocate the slots, reducing waiting lists as well as DNAs.

The system is easy for patients to use. They also have the option of contacting us at a later date or for the call centre to ring them. The service is managed off-site, with our provider sending daily activity reports.

Courtesy Call used minimal data from the patient administration system, using encrypted e-mail to ensure we did not fall foul of data protection rules.

The service is to be implemented in all clinics. At the end of April, reminder calls started in pain relief, opthhalmology and ear, nose and throat, with other specialties to be introduced over six months.