Last year 49,000 appointments were missed at Croydon Health Services NHS Trust resulting in significantly high delayed or lost income. Over 50% of patients simply forget about their appointment or symptoms resolve, but with no easy way to alert hospitals, patients become an expensive Did Not Attend (DNA) statistic.

This not only leads to under payment by results (PbR) but is a lost opportunity for another patient to be seen, extending waiting lists and wasting clinician’s precious time.


National audits reveal DNA’s reduce by up to 65% with a reminder. With this in mind, Croydon Health Services went to tender to find a professional provider with following criteria:

• Reduce current DNA rates of over 15%
• Provide a mix of communication technologies to engage every patient group
• Fully managed service including ongoing support and training.
• Automatic reporting on reminder outcomes for efficient slot reutilisation


Healthcare Communications were awarded the contract by providing the full package at a lower operational cost and Envoy Messenger was implemented to collate data from all channels and report on outcomes in real time.

SMS and Interactive Voice Message (IVM) were introduced with a refined communication plan that blends cost effective technologies for the best result. For example if an SMS was not delivered within a set time frame, an IVM automatically follows and will attempt contact a certain amount of times before changing to another channel.

Pilot success has led to Trust wide roll out and now over 30,000 SMS and 2500 IVM’s are sent monthly. To engage all patient groups and capture responses where connection has not been made via SMS and IVM, agent calls are a key component to the communication portfolio.


In November 2014, Agent calls were introduced to contact hard to reach patients, when landline only details are given and to accommodate certain patient preferences. The over 65’s demographic are more receptive to live
agents and automatically receive a prompt this way and it’s an important channel to reach vulnerable patient groups. The benefit of an Agent call is flexibility in delivery time and calls are scheduled to achieve the highest
contact outcome.


  • 130 reutilised slots a month are captured from the over 65’s and SMS and IVM’s that are not completed.This equates to PbR income gains of £15,600 a month from agent calls alone!
  • Of the 25,000 appointments reminders sent a month, 2500 are delivered by an agent call contributing to an overall 10% DNA reduction.
  • Improved patient experience with a conversational reminder prompt. Patients can now easily reply with intentions including rebook and cancel by channel preference.
  • Automatic reporting of reminder outcomes means booking staff can quickly reuse cancelled appointments reducing waiting times.

36,000 messages are now sent monthly at Croydon Health Services, resulting in over 90% of patients
receiving an appointment reminder. Cashable efficiencies have increased through slot reutilisation and patients can now alert hospitals of a rebook or cancel resulting in better access to care.

To find out more call 0845 9000 890 for a hassle free chat about DNA reduction in your department