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Research demonstrates that non-attendance at healthcare appointments is a waste of scarce resources; leading to reduced productivity, increased costs, disadvantaged patients through increased waiting times and demoralised staff. The purpose of this paper is to investigate non-attendance and implemented interventions to improve practice.

A mixed methods service audit took place in a primary care psychological therapies service. Existing service guidelines and reporting systems were reviewed. A cross-sectional design was used to compare a year’s cohort of completers of cognitive behavioural therapy (CBT) (n=140) and drop-outs (n=61).

Findings suggested contrasting guidelines and clinically inaccurate reporting systems. The overall service did not attend (DNA) rate was 8.9 per cent; well below rates suggested in the literature. The drop-out rate from CBT was 17 per cent. The most influential factor associated with CBT drop-out was the level of depression. The level of anxiety, risk ratings and deprivation scores were also different between completers and drop-outs. The main reasons given for non-attendance were forgetting, being too unwell to attend, having other priorities, or dissatisfaction with the service; again these findings were consistent with prior research.

A range of recommendations for practice are made, many of which were implemented with an associated reduction in the DNA rate.

Non‐attendance for first appointments in primary care mental health services represents a major service delivery challenge. Previous research identified how invitation type can influence attendance rates and a localised study was therefore carried out to examine the most effective invitation method and to inform local service guidelines. This exploratory study aims to consider the rate of non‐attendance to assessment for clients referred for psychological therapy in relation to invitation type.

In total, 521 invitations to initial assessment were sent over a three month period with clients being drawn from a rolling waiting list of referrals and invited to attend initial assessment by letter, telephone, or telephone with a telephone reminder. Non‐attendance rates were examined and findings compared across invitation type.

The study concluded that telephone invitations followed by a telephone prompting reminder significantly reduced non‐attendance to initial assessment appointments.

The findings highlight how using phone based invitation to assessment with a phone reminder can increase attendance rates and improve service efficiencies locally and more widely. There were several limitations to the research project including key variables not included or controlled for which it is felt may have biased the findings and the small effect size.

The findings of the present study extend and build on previous research in the area of attendance, particularly in relation to the provision of localised evidence from which to develop and improve local, national and international service delivery.

The aim of this paper is to investigate reasons for treatment non‐attendance for dual diagnosis women in secure psychiatric settings.

A semi structured interview was used to investigate patients' reasons for session non attendance on the day of non participation across four wards. Reasons for non attendance were grouped using the mulifactorial offender readiness model (MORM) categories of affective, volitional, behavioural, cognitive and external. Assignment of responses to categories was undertaken by a two person team and inter rater reliability was assessed.

Patients' rates of attendance varied by ward and level of security (low vs medium); and diagnosis. Systematic enquiry about the reasons for non attendance led to increased session attendance. Reasons for non attendance were cognitive reflecting negative evaluations of treatment and treatment outcomes. Psychological therapies and educational sessions were deemed the most important along with one‐to‐one clinician appointments.

Issues of treatment engagement and the timing of treatment interventions are major issues in the care of secure psychiatric patients, particularly those with a primary diagnosis of personality disorder. Findings highlight the importance of systematic enquiry about reasons for non attendance and suggest potential interventions designed to improve engagement.

Missed appointments within the National Health Service (NHS) are a drain on resources, associated with not only considerable time and cost implications, but also sub-optimal health outcomes. This literature review aims to explore non-attendance within the NHS in relation to causes, impacts and possible mitigation of negative effects of missed appointments.

MEDLINE, CINAHL Plus and PubMed were searched with a date range of 2016–2021. Databases were searched for peer-reviewed articles published in English addressing non-attendance of adults within the NHS. Studies were excluded if they were theoretical papers, dissertations or research concerning patients aged under 18. A total of 21 articles met the inclusion criteria and were selected for analysis.

The results indicate a significant association of non-attendance and poor health outcomes. Patients from a lower socioeconomic status, adults aged over 85 and those with multiple co-morbidities are more likely to miss appointments. The most commonly reported patient-centred reasons for failing to attend were forgetfulness, transportation difficulties, and family commitments. Practice-specific reasons were cited as inefficiencies of the appointment booking system, failure of traditional reminders and inconvenient timings. Interventions included text reminder services, the inclusion of costs within reminders and enhanced patient involvement with the booking process.

Non-attendance is complex, and to secure maximum attendance, targeted interventions are required by healthcare facilities to ensure patient needs are met. The adaption of scheduling systems and healthcare services can assist in reducing DNA rates.

This paper aims to contribute to the special issue theme by exploring the perceptions of anti‐consumption and resistant practices of adolescents by their peer group in the context of high school prom attendance.

This paper employs a mixed methods approach involving 12 in‐depth interviews with those who had attended a high school prom in the last three years and open questions on a survey to adolescents.

Four main perceptions of non‐attendance were identified: non‐choice, risk aversion, passive disengagement and intentional disengagement. Perceptions of anti‐consumption and resistance will have social implications for the non‐attendee/s but the extent to which non‐attendance is viewed negatively will also be moderated by existing social status of the non‐attendee/s.

Possible causes for avoiding consumption have been previously considered, however, as yet unexplored are how those who do not consume are perceived by their peers and how this manifests itself in relation to group affiliation, attendees' perception of “self” and social norms.

On average, the National Health Service (NHS) loses annually £360 million in opportunity costs due to non‐attendance of outpatient appointments (Stone et al, 1999). In addition to draining healthcare resources, failure to attend clinical appointments incurs personal costs. Mobile phone technology has been applied successfully to reducing appointment non‐attendance and improving clinical outcomes for patients with physical illnesses. However, it is unclear whether these applications can be extended to patients with severe and enduring mental disorders. We conducted a trust‐wide survey of 141 psychiatric inpatients of the Oxleas NHS Foundation Trust (82% of the Trust's total inpatient population) to establish how many respondents owned a mobile phone (62%), could use text‐messaging services (62%) and were willing to use the latter as a means of communication with the Trust (80%). Compared to patients with psychotic illnesses, those with non‐psychotic illnesses reported higher rates of mobile phone ownership (78% versus 55%, p=0.01), ability to use text messaging (76% versus 56%, p=0.03) and willingness to receive text messages from the Trust (90% versus 76%, p=0.05). The results of the survey were used to inform the planning of a pilot study aimed at reducing non‐attendance rates of outpatient appointments in Oxleas.

There is increasing recognition that, wherever clinically appropriate, the needs of mentally disordered offenders should be met by health and social services rather than the criminal justice system (Cohen & Eastman, 1997). Many trusts now make separate service provision for this client group, but there has been little research into the role of applied psychology in these services. This study consists of an exploratory audit of the referrals to applied psychology in a multidisciplinary mentally disordered offenders team. Client characteristics as well as referral characteristics were explored. One of the main results of the audit was that clients referred for outpatient groups (who were not normally known to the team prior to referral) had significantly higher rates of non‐attendance and drop‐out than clients referred for other reasons. Outpatients in general also had higher rates of non‐attendance and dropout than inpatients. The main conclusion of this study is that applied psychology resources may be best used in the provision of services to clients known to the team and that, as inpatient work may be more productive, it should perhaps be the priority for psychologists working with this client group.

Other business education literature, particularly in the field of economics, has developed theories in respect of the reasons for non‐attendance of lectures and the positive correlation between class attendance and academic performance. The aim of this paper is to determine the generalizability of these theories to a large accounting class in South Africa.

This paper is a differentiated replication of the study by Paisey and Paisey, who provided initial evidence of the generalizability of these theories to a small accounting class in Scotland, employing a research questionnaire and the analysis of quantitative and qualitative data.

The reasons given for the non‐attendance of lectures generally correspond with those previously reported. Certain differences that are identified are likely a result of specific country or economic factors. This study found a significant positive correlation between class attendance and academic performance; however, the correlation is low and not very meaningful. Further analysis reveals some difference between language groups suggesting that culture and ethnicity may have an effect on the relationship between class attendance and academic performance.

This paper raises questions as to the generalizability of prior research on class attendance and academic performance. The findings of this study suggest other factors, including students' economic, cultural and ethnic backgrounds, are likely to affect associations between class attendance and academic performance.

This paper aims to determine the reasons why patients miss clinic appointments and to ascertain patients' views on the implementation of reminder systems and penalty fees to reduce the rates of did not attend (DNAs). Overall, the paper seeks to establish novel ways to run a more efficient out‐patient department (OPD) service to improve waiting times and access for patients to limited neurology resources.

A questionnaire‐based study was approved by the audit committee and was offered to 204 out‐patients attending the neurology clinics over a three‐month period (July to September 2009). The patients' demographic details and non‐attendance records were reviewed. The paper aimed to ascertain, from the patients' perspective, why people failed to attend clinic appointments. Each participant was asked their views on how they felt their public hospital service might reduce the number of DNAs at their neurology OPD.

A total of 204 patients took part. Participants had a mean age of 31 years (range 25‐75 years) with a modal peak in the 26 to 35 age bracket. Almost 10 per cent of those surveyed admitted to missing a hospital out‐patient appointment in the past. The most common reason was that they simply “forgot” (28 per cent). DNA rates by age range were proportionally similar to the overall age profile of attenders. Over 55 per cent said they would like a pre‐appointment reminder via a mobile telephone text message, 19 per cent preferred a pre‐appointment telephone call, and 19 per cent an e‐mail. Of those surveyed, 47 per cent said they would be willing to pay a fee on booking that could be refunded on attending for their appointment. The majority of these felt €20 was the most appropriate amount (39 per cent). The rate of acceptance for various fee amounts was uniform across age ranges. Over half (52 per cent) said that they would agree to a “buddy” system whereby the appointment reminder was sent to the patient but also a nominated friend or relative.

Non‐attendance rates at the neurology clinics in our institution are high with almost 10 per cent of attendees admitting to missing an appointment. One of the main reasons why people did not attend was because they simply “forgot” that they had an appointment and the patients favoured a text messaging reminder system to help reduce non‐attendance. Almost half of the respondents said that they would be willing to pay a refundable booking fee.

The purpose of this paper is to examine smallholders’ preferences and willingness to pay for microcredit products with varying attribute combinations, in order to contribute to the debate on the optimal design of rural microcredit.

Data used in this study are based on a discrete choice experiment from 552 randomly selected respondents. Mixed logit and latent class models are estimated to examine the choice probability and sources of preference heterogeneity. Endogenous attribute attendance models are applied to account for attribute non-attendance (ANA) phenomenon, focusing on separate non-attendance probability as well as joint non-attendance probability.

The results demonstrate that preference heterogeneity and ANA exist in the smallholder farmers’ microcredit choices. Averagely, smallholder farmers prefer longer credit period, smaller credit size, lower transaction costs and lower interest rate. Guarantor collateral method and installment repayment positively affect their preferences as well. Moreover, respondents are found to be willing to pay more for the attributes they consider important. The microcredit providers are able to attract new customers under the current interest rates, if the combination of attributes is appropriately adjusted.

This study contributes to the debate by assessing the preference trade-off of different microcredit attributes more comprehensively than in previous analyses, by taking preference heterogeneity and ANA into account.