P080 Risk factors associated with nonattendance at new general dermatology appointments: a single-centre study

Abstract Reducing nonattendance (NA) at outpatient appointments is a key priority for the National Health Service as part of the elective care recovery programme. It is also a recommendation of the Getting It Right First Time national report for dermatology. NA increases the cost of healthcare, wastes precious resources and adversely affects patient outcomes. NA at new outpatient appointments in particular increases waiting-list sizes. We conducted a retrospective observational study to identify risk factors for NA at new general dermatology appointments at our centre following general practitioner referral on the 18-week pathway. The study period was August to November 2024, and the average NA rate during this time was 9.0%. Patients had been sent several text message reminders at intervals before their appointment, and had been given contact details for the centralized booking team in case a reschedule was required. Overall, 50 attendees and 50 nonattendees at new appointments in the general dermatology clinic were consecutively identified on the trust’s electronic record system during the study period. Data were collected on the patients’ age, sex, ethnicity, distance from home to hospital, reason for referral, duration of the condition at the time of referral, and waiting time between referral date and appointment date. There was a significant difference in the waiting time for an appointment between attendees and nonattendees (median 158 vs. 284 days, P = 0.005, Mann–Whitney U-test). There was no significant difference between attendees and nonattendees in patient age (median 41 vs. 36 years), distance from home to hospital (median 5.0 vs. 4.7 km) or duration of the condition at the time of referral (median 72 vs. 104 weeks, P = 0.62). Neither sex nor ethnicity was found to be associated with NA in this patient sample (χ2-test). This study highlights that prolonged waiting times were the most significant risk factor for NA at a new general dermatology appointment in our patient population. Potential explanations include resolution of the condition by the time of the appointment, seeking care from an alternative provider, or forgetting the appointment due to the extended wait. Efforts to reduce waiting times could therefore be a key future strategy to lower NA rates at new appointments. As reasons for NA are complex and may vary regionally, replicating this study at other centres could provide valuable insights into regional risk factors, informing targeted strategies to address NA in dermatology services.