Quality Improvement Project Transforming Service at West Quay Medical Centre

The West Quay Medical Centre in Barry has undertaken a quality improvement (QI) project to reduce the number of patients not attending their appointments (DNAs) and to ensure that patients get to see the right health care practitioner.

At the centre, which covers 14,000 patients across Barry, Dr Sue Goodfellow and her team have made a significant change in reducing the numbers of patients who did not attend (DNA) their appointments, freeing up additional appointments for patients but also using the doctors and other health care practitioner’s times more effectively.

There were three key areas for effecting this change:

  • Re-framing the behaviour of always “seeing a GP” – thereby taking a prudent health care approach, in encouraging seeing the best health care practitioner for their specific needs.
  • Redesigning the Appointment system to give appropriate access to the skills of all the Multi-Disciplinary Team.
  • Eliminating unwarranted demand for appointments (Potential waste: Including DNAs, seeing the wrong Health Care Practitioner and avoiding revolving door patients etc.)

The team has also undertaken analysis of patient behaviour to identify the reasons for DNAs, and have implemented a number of small tests of change, including:

  • Understanding why Text message reminders are not always effective, sometimes something as simple as the wrong contact details
  • Adding a voicemail cancel appointment option on automated phone message, which means not waiting on the phone to speak to a receptionist
  • Using web and social media to promote the many options available for cancelling an appointment
  • Changing the approach to DNA events – which is encouraging people, especially those repeatedly cancelling and to updating the DNA template letter
  • Encouraging a collective responsibility approach to precious appointment resources (#don’t need it, can’t use it, give it back for another patient)
  • And finally – Coming soon – cancellation via the West Quay Medical Centre website with more administrative functionality increasing ease of use and available to patients 24/7

Dr Sue Goodfellow, QI Lead at West Quay Medical Centre and QI Faculty Lead at Health, Education and Improvement Wales (HEIW), said: “I am delighted that we are already starting to see positive results of transforming our approach to DNAs and opening up appropriate access for patients to the whole Multi-Disciplinary Team.  

“Not only is working in this way ensuring more appropriate and efficient allocation of our resources, but it is delivering a much improved service at the centre for our patients too.

“I’d like to thank the whole West Quay Medical Centre team for committing to delivering on this quality improvement, and look forward to observing longer term outcomes.”


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