Croydon neurology: a nudge to attend outpatient appointments

<h3></h3> There are 7.8 million missed neurology appointments annually in the UK accounting for 8% of the total number of appointments. The GIRFT report has recommended multiple methods of reducing this number to increase care and increase efficiency. Behavioural economics (nudge theory) offers very low cost interventions and has been used widely in the commercial and governmental sectors. We aimed to compare monthly missed appointment rates in neurology as well as rheumatology and elderly care using Hospital specific data for 2 months prior to and after the intervention which is the addition of the following to appointment letters ‘<i>Nearly 90%</i><i> of people referred to Croydon Hospital Neurology department keep their appointments or cancel them in advance.</i>’ Data collection ongoing (will be available by May) We anticipate that this nudge will have little effect on the missed appointment rate. This was already falling due to implementation of GIRFT report to call all non-attenders. Other reasons why we may not find a significant change are: the intervention period was very short, there was insufficient time for patient/public engagement, with no qualitative understanding of local reasons for missed appointments and no trial of other alternative nudge interventions.