title: Children's missed healthcare appointments: professional and organisational responses.
abstract: This National Society for the Prevention of Cruelty to Children (NSPCC) funded UK study sought to examine organisational and professional responses to children's missed healthcare appointments.
  
  
  
  The study comprised two parts: phase I was a web-based scoping and systematic analysis of UK National Health Service healthcare organisations' internal policies on missed appointments. Phase II involved a case study of how missed appointments were managed within one hospital trust, including interviews with hospital-based staff, review of organisational data and examination of policies and 'systems' in place.
  
  
  
  Policies accessed were of variable quality when benchmarked against a predetermined set of evidence-based standards. Additional material (eg, board minutes) gleaned through the searches found an apparent disconnect between nationally determined safeguarding requirements and strategies to reduce the cost pressures arising from missed appointments. Findings from the case study included the continuing use of the adult-centric term 'did not attend' (DNA), the challenges that may be inherent in attending appointments (with concomitant sympathy for parents) and a need to further explore general practitioner responses to DNA notifications, particularly given the acknowledged association between missed appointments and child maltreatment.
  
  
  
  The web-based scoping exercise yielded a small number of organisational policies. These were of variable quality when rated against predetermined standards. Other material gathered through the search strategy found evidence that 'missed appointment' strategies aimed at reducing costs did not always acknowledge the discrete needs of children. The case study findings contribute to an understanding of the complexities and challenges of responding to a missed appointment and the importance of taking a child-centred approach.
authors.affiliation: Faculty of Health & Life Sciences, Oxford Brookes University, Oxford, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Appleton
authors.affiliation: Safeguarding Children Consultant & Visiting Academic, University of Southampton Highfield, Southampton, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Powell
authors.affiliation: Faculty of Health & Life Sciences, Oxford Brookes University, Oxford, UK.
authors.forename: Lindsey
authors.initials: L
authors.lastname: Coombes
mesh_terms: D001071:Appointments and Schedules; D001291:Attitude of Health Personnel; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D006291:Health Policy; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010564:Personnel, Hospital / Q000523:psychology; D017010:Reminder Systems; D013222:State Medicine / Q000458:organization & administration; D009626:Terminology as Topic; D006113:United Kingdom
keywords: Child Abuse; Children's Rights; Missed Appointments; Qualitative research; Was Not Brought