P118. Improving breast services – It's in the DNA

Published Date: 19th July 2016

Publication Authors: Chagla LS

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Introduction

All breast referrals must be seen within 2 weeks. The sheer volume of referrals from primary care makes this a challenging target to achieve. It is therefore extremely important that clinics are utilised appropriately and that every effort is taken to minimise non-attendance. Current hospital policy is to re-appoint all patients referred under the 2 week rule who do not attend (DNA) their first appointment. The purpose of this audit was to review all the DNAs and see if giving a second appointment is cost effective or is in fact a useful policy. 

Method

A retrospective review of all new breast referrals who did not attend their appointment over a 12 week period (01/08/14-31/10/2014) was performed. 

Results

A total of 56 clinic appointments were not attended by patients over the 12 week period. Only 33.9% (n = 18) of those appointments re-issued were attended. Out of those patients who attended no cancers were identified and 44.4% (n = 8) had no clinical/radiological abnormality. 

Conclusion

Our hospital policy of automatically sending a second appointment does not work for breast 2 week referrals and is a major waste of resources. It is misinterpretation of National Guidelines that "no DNA should be discharged without Consultant review of the referral information." Accepting Consultant review rather than blanket policy would have saved our Trust approximately 14,000 in 3 months.

Byrne, C; Chagla, L. (2015). P118. Improving breast services – It's in the DNA​ . European Journal of Surgical Oncology. 41 (6), S60.

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