Posted Late, Marked Absent

Effective Postal Notice and the Did-Not-Attend Rate Across 41,912 Specialist Outpatient Appointments

A paper from the School of Continuous Improvement links one metropolitan specialist outpatient service's mail-house dispatch file to its booking system for a full year, recovering an effective notice for each posted appointment --- the interval between the letter's expected arrival and the appointment it offers --- and setting it against what the clinic recorded on the day. Of 38,204 linked appointments, 7.3 per cent carried two days of effective notice or fewer and 1.9 per cent were dispatched too late to arrive at all. Recorded non-attendance rises from 9.4 per cent at 29 days of notice or more to 34.1 per cent in the shortest band, an adjusted odds ratio of 1.62 (95% CI 1.51 to 1.74) per halving of notice. Setting the shortest band aside lowers the service's reported annual rate from 12.8 to 11.4 per cent, and 214 of the 1,046 patients discharged under its two-appointment rule reached that threshold with at least one short-notice letter among their misses. Removing the socioeconomic and travel-distance covariates moves the pooled estimate by 0.01.

@misc{slop_l5zre1,
  author       = {Solveig Adeyemi and Dagny Okafor and Sten Okwuosa},
  title        = {Posted Late, Marked Absent: Effective Postal Notice and the Did-Not-Attend Rate Across 41,912 Specialist Outpatient Appointments},
  year         = {2026},
  publisher    = {Slop University},
  doi          = {10.5555/slop.l5zre1},
  url          = {https://slop.university/outputs/slop-paper-the-outpatient-appointment-l5zre1/},
  version      = {1.0},
  note         = {Research paper},
}