Scheduling medical appointments later in the week can increase patient attendance by over 10%, according to a new study.
Researchers from the Universities of York, Bath, and London School of Economics and Political Science have shown that patients prefer Friday appointments to Monday appointments and are more likely to attend medical appointments scheduled at the end of the week.
The research, published in PLOS One, has implications for appointment scheduling in both primary and secondary care and could lead to improved patient health outcomes.
Missed appointments are a long-standing problem for the NHS, which lead to increasing costs and negatively impacting patient health. NHS analysis in 2019 found that more than 15 million GP appointments are wasted each year because patients fail to turn up or warn surgeries they will not be attending.
The researchers analysed patient attendance at a community mental health clinic in Scotland. After moving patient appointments later in the week, they found attendance increased by 10% over a year.
The results build on previous work by the same team which looked at the effect of moving appointments to the end of the week in both hospital and GP settings. They found that patients were more likely to attend an appointment on a Friday and miss one on a Monday.
The possible reasons behind missed appointments can often be complex and are often associated with patients with comorbidities and those with high levels of deprivation.
Dr David Ellis, from the University of Bath, said: ‘We don’t fully understand what’s causing patients to favour end of the week appointments over those at the start of the week, but it could correlate with how people mentally associate with different days of the week, which typically becomes more positive as the week progresses. The start of the week can sometimes feel frenetic, balancing work and life schedules.’
He added: ‘People often avoid medical appointments because they’re fearing bad news, or they’re dreading a particular treatment, or they feel they don’t get on well with the staff. It could well be that attendance improves as mood improves, and later in the week, people find it easier to face medical appointments.’
The researchers believe that attendance could be increased further by sending reminder texts and phone calls, already used in many healthcare settings but often requiring extra costs. ‘Weekday intervention’ is unlikely to incur direct implementation costs as it uses a scheduling system already in use. The burden of missed healthcare appointments is so significant that even a small reduction in missed appointments can secure tangible benefits.
Dr Rob Jenkins from the University of York said: ‘We have taken a very specific look at appointment scheduling in this study, rather than considering the broader issue of patient demographics.’
He added: ‘These weekday effects are smaller compared to demographic effects but appointment allocation policy is theoretically more straightforward to address. It won’t be suitable for all clinics, and it won’t be possible for all staff rotas, but it’s potentially an inexpensive option to explore to address the long-standing, thorny issue of missed appointments.’
