Non-attendances (DNAs) and cancellations are a very costly waste of resource within the NHS and so it is important to have a focused plan of action to proactively manage them. The Trust recognises that people may choose not to attend appointments, or discontinue contact with the services we provide for them. There will be occasions where a person's non-attendance is an indicator that :

• • they may be at risk to themselves or others through deterioration in their mental health, or other issues preventing them from attending.

• • Therefore, any failure of planned contact should be regarded as a potentially serious matter and should lead to an assessment of potential risk. Hence we aimed this study to see if trust policy of DNA and disengagement is being followed.

Data were collected for 51 patients who missed their scheduled appointment between February and August 2021, using a predesigned questionnaire tool.

Out of the 51 patients, 37 of them Did not attend the initial assessment whereas 14 of them did not attend follow-up appointments.

18 patients had the diagnosis of depression, 9 of then had anxiety as the diagnosis and 8 had the diagnosis of personality disorder. Please see figure above for distribution of Mental Health diagnosis.

98.1% patients were notified adequately and for all the patients, letter was sent to the patient and the GP.

In 50.9% cases Risk Assessment was completed (although 37 patient did not attend, they were already known to our services). In 25% of cases, risk assessment was updated.

Review of the Contingency plan was done in case of 26 patients.

Out of the 51 patients, family was contacted for only 3 patients. Remaining 48 patients other known contacts were contacted in 4 cases.

Out of the remaining 44 patients, 3 patients were referred for home visits or AHMP.

Out of the remaining 41 patients, police/welfare check was done for 4 of them.

The remaining 31 patients were discharged from the services after they did not respond to our multiple correspondences including phone calls and letters.

Though trust policy is being followed to a good extent in regards to adequately notifying and contacting service user, offer another appointment and informing GP, we are failing to adhere to trust policy in regards to updating risk assessments, review crisis plans or doing welfare checks.