After the Empty Chair: Responding to a Missed Somerset Appointment

It is an uncomfortable moment. You had intended to be there, but the appointment time came and went. Perhaps a bug kept you at home, the bus did not turn up, or the date had been written down incorrectly. Later, a letter arrives referring to a ‘did not attend’ — often shortened to DNA. The language sounds formal, even accusatory, but it is best understood as an administrative record rather than a verdict on your character.

In Somerset, as across the NHS, clinics use DNA notices to understand what happened to an appointment and to manage limited capacity. One missed appointment is usually a conversation, not a closed door. The important thing is to respond promptly and clearly, so the service knows whether you still need care and what should happen next.

What a DNA notice actually records

When a clinic records a DNA, it is noting that the appointment was not attended and that the service was not told in advance. This information helps the clinic account for clinical time, update waiting lists and decide whether further contact is needed. It does not, by itself, mean that you have been removed from a waiting list or discharged from a service.

Services do vary. Some will send a letter inviting you to contact them. Others may close the appointment offer if they do not hear back within a set period. Repeated non-attendance can lead to a referral being returned to your GP, but that is a separate decision and usually follows more than one missed appointment. The first step is always to find out what the service has recorded and what it now expects of you.

Why the clinic may ask you to get in touch

A clinic cannot plan safely if it does not know whether you still need the appointment. If you missed it because of illness, transport problems, a caring responsibility or a simple diary mix-up, telling the service helps them decide whether to offer another date, signpost you elsewhere or ask your GP to refer again.

Check the wording of any letter you receive. Some services ask you to call within a certain number of days. Others ask you to reply in writing or through an online portal. If the letter gives a deadline, try to respond before it passes. If you cannot find the letter, call the main hospital switchboard or the number for the service and ask to speak to the appointments team.

The first call: what to say

Have your NHS number, date of birth and address to hand if you can. Then keep the conversation simple and specific. You might say: ‘I missed an appointment on [date] at [time] with [service]. I could not attend because [brief reason]. Please could you tell me whether my referral is still open and what I should do next?’

It is reasonable to ask three practical questions. First, is my referral still active? Second, will I be offered another appointment, or do I need to be referred again by my GP? Third, could you add a note to my record explaining why I could not attend? If the service confirms a next step, ask whether you will receive that in writing or through the NHS App, so you have a clear record.

If speaking on the phone is difficult, ask whether there is an email address or online form you can use instead. Accessible communication should be part of the conversation, not an afterthought.

Will it affect my waiting-list position?

This is the question many people understandably worry about. The honest answer is that it depends on the service and its policy. Some services will place you back into the queue from your original referral date. Others may calculate a new wait from the date you re-contact them. A few may ask your GP to make a fresh referral. None of this is universal, so it is worth asking directly: ‘How will this affect my position on the waiting list?’

If you are waiting under an urgent or suspected cancer pathway, do not wait for a letter before acting. Call the service or your GP promptly and explain what happened. Urgent pathways are designed to move quickly, and a short delay in making contact can matter.

If illness, transport or caring stopped you

Illness is a straightforward reason, and clinics hear it often. You do not usually need to provide detailed medical evidence, though you may be asked for a brief explanation. If you were in hospital or under the care of another service at the time, say so.

Transport difficulties are also common in a county like Somerset, where journeys to hospital can be long and public transport links may be limited. Ask whether the service can note the issue and whether there is any travel support or flexibility available for a future appointment. If caring responsibilities kept you at home, explain that too. It may be possible to arrange a different time or to discuss adjustments for future visits.

If it was a simple diary mix-up

There is no need to over-explain. A plain statement is enough: ‘I had the wrong date in my diary and I am sorry I missed the appointment.’ Then move to the practical question of another offer. Use the experience to check how you receive reminders. If your contact details have changed, update them with the hospital and your GP. If you use the NHS App, check that your contact preferences are current.

Asking for a note on your record

It is entirely reasonable to ask for a short note to be added to your record explaining why you could not attend. This helps the next clinician understand the context and avoids the missed appointment being read as disengagement. You can ask for the note to record that you made contact, the reason you gave and any agreed next step. If you need confirmation that you called, ask for a reference number or for the outcome to be sent to you in writing.

If you cannot get a clear answer

Most services respond well to a prompt call, but sometimes the route is not obvious. If you have tried the appointments line and still cannot establish whether your referral is open, contact the service’s Patient Advice and Liaison Service (PALS) or the hospital’s complaints and patient advice team. Keep a note of dates, times and the names of people you speak to. If your GP made the referral, their practice may also be able to check the referral status on the system.

A final word of reassurance

Missing an appointment is not a moral failing, and it does not usually mean that Somerset clinicians no longer want to see you. Clinics understand that illness, transport and ordinary life can get in the way. What helps most is a prompt, clear response: explain briefly what happened, ask what the service needs from you, and confirm the next step. One missed appointment is usually a conversation — and a conversation is often all that is needed to get your care back on track.