What the NHS can teach us about reducing DRT No-Shows

We at Trapeze have been considering the issue of costly ‘No Shows’ in Demand Responsive Transport (DRT). In exploring this problem we considered related sectors and found a fascinating piece of research from the National Health Service that we thought we would share with you.

As most people are well aware, the NHS is facing similar financial challenges to DRT service providers. And in another striking similarity, the NHS’s funding crisis is exacerbated by no-shows (usually called Did Not Attends, or DNAs) – which cost around a billion pounds each year.

The NHS has attempted to tackle this through the use of email and text reminders, and empowering patients to check, book and cancel appointments and order repeat medication online. Many pilots and studies have been undertaken, but perhaps none as revealing as an intriguing piece of research undertaken by Barts NHS Trust and the Department of Health behavioural insights team.

The trial, which focused on the content of messages sent to notify patients of appointments, found that reminder messages that specifically mentioned the specific cost impact of non-attendance, had a significant impact on levels of missed appointments. The message that proved by far the most effective stated:

We are expecting you at St Barts Hospital on Sep 26 at 2.30. Not attending costs NHS £160 approx. Call 02077673200 if you need to cancel or rearrange.

Given widespread public awareness of local authority transport budgets, could this type of approach also be effective in reducing No Shows in Demand Responsive Transport? A simple implementation might involve the inclusion of the specific cost impact within any e-mail and SMS notifications, for example:

You have a trip scheduled for tomorrow: 11:00 – from 216 High Street to Middlegate. Late cancellations and no-shows cost approx. £30. Wish to rearrange? Just reply with “cancel”.

It’s a fascinating concept – and one that we intend to explore with Trapeze’s new Ripple SMS notifications system.

If you are interested in exploring how this type of approach could reduce your No Shows then please get in touch – we would be delighted to hear from you.