--- title: "NHS DNA rates in primary care: empty slots have a cost" description: "NHS England counted 16 million GP DNAs in 2025 (4.3%); May 2026 attendance was 89.6%. Why forgetfulness and late arrival still tax booked capacity." url: https://www.getarbol.com/en/blog/nhs-dna-rate-primary-care/ lang: en --- # NHS DNA rates in primary care: empty slots have a cost NHS England counted 16 million GP DNAs in 2025 (4.3%); May 2026 attendance was 89.6%. Why forgetfulness and late arrival still tax booked capacity. [**Norbelys Chirinos** Founder · Product](https://www.getarbol.com/en/blog/authors/norbelys-chirinos/) February 20, 2026 10 min read England’s primary-care diary is busier than most public debates admit — and still leaks capacity through Did Not Attend (DNA). NHS England’s March 2026 “Tap the App” campaign reported that patients did not attend **16 million** GP appointments in 2025, a DNA rate of **4.3%** (1 in 23), against **376 million** GP-practice appointments arranged that year — **8.4 million** more than in 2024. The same release said a patient survey found **12%** had forgotten an appointment and **11%** had arrived too late, with nearly **1 in 4** people saying they had missed an NHS appointment for forgetfulness or lateness. Separately, NHS England Digital’s [Appointments in General Practice, May 2026](https://digital.nhs.uk/data-and-information/publications/statistical/appointments-in-general-practice/may-2026) bulletin put attendance at **89.6%** for that month. The need many practices under-measure is not “more appointments” in the abstract — it is protecting the ones already booked. Key takeaways - NHS England reported 16 million GP DNAs in 2025 — 4.3% of appointments, or 1 in 23 — equivalent in its framing to an entire day of missed appointments at every GP practice each month. - GP practices arranged 376 million appointments in 2025, 8.4 million more (2.3%) than in 2024, according to the same NHS England release. - A Censuswide survey for NHS England found 12% of people had forgotten an appointment and 11% had arrived too late; nearly 1 in 4 said they had missed an NHS appointment for those reasons. - NHS England Digital’s May 2026 bulletin recorded 89.6% attendance across general practice appointments — a monthly attendance figure, not a substitute for a practice’s own DNA dashboard. - Reminders and easy rearrange paths do not create clinicians; they recover slots that were already staffed and then lost. ## The invisible cost is already inside the appointment book Create-need pieces fail when they invent a crisis. This one does not have to. The crisis is already booked: a clinician’s time reserved, a room held, a downstream pathway delayed — and then an empty chair. DNA is not a soft cultural complaint. It is unused capacity sitting next to a waiting list that never saw the gap open in time to fill it. The March 2026 NHS England release is useful because it refuses the false comfort of “we just need more slots.” Practices already delivered a larger book in 2025 than in 2024. The campaign’s operational claim is narrower and harder: a meaningful share of those slots never converted into attended care, and a large minority of surveyed patients named forgetfulness or lateness as reasons they had missed NHS appointments. That is a contact-and-confirmation problem as much as a workforce problem. Reading DNA next to access volume also prevents a second mistake: treating England’s appointment counts as proof that “access is fine.” [NHS GP appointment access](https://www.getarbol.com/en/blog/nhs-gp-appointment-access/) already separates booked activity from phone intake. This post sits on the other side of the same ledger — what happens after the booking exists. ## What 2025 and May 2026 actually say — and what they do not Keep the two publications distinct. NHS England’s campaign statistics summarise calendar year 2025 DNA and activity, plus a patient survey. NHS England Digital’s May 2026 bulletin is a monthly extract from appointment systems, including attendance. They reinforce each other; they are not the same spreadsheet. England · primary care DNA and attendance The figures the national releases actually published 16m GP appointments not attended in 2025 NHS England, Mar 2026 4.3% DNA rate — 1 in 23 appointments NHS England, Mar 2026 376m GP-practice appointments arranged in 2025 NHS England, Mar 2026 +8.4m Extra appointments vs 2024 (+2.3%) NHS England, Mar 2026 12% / 11% Survey: forgot / arrived too late Censuswide for NHS England 89.6% Attendance in May 2026 GP appointments NHS England Digital Fuente: NHS England (Tap the App, March 2026); NHS England Digital (May 2026) Several boundaries matter before anyone pastes these into a board pack: - **4.3% is a system DNA rate for 2025 GP appointments**, not your practice’s specialty mix, deprivation profile, or reminder stack. - **89.6% attendance in May 2026** is the complementary framing for one month in the official [Appointments in General Practice](https://digital.nhs.uk/data-and-information/publications/statistical/appointments-in-general-practice) series — useful for trend context, dangerous if blended with the 2025 annual DNA total into a fake “spring composite.” - **Survey shares are not DNA rates.** “Nearly 1 in 4 missed because they forgot or arrived late” describes self-reported reasons among surveyed adults in England, not the share of all appointments lost to those causes. - **National series still only see what entered the book.** Calls that never became appointments never enter the DNA denominator either — the same methodological limit discussed in the access post. The arithmetic that matters locally is simpler than any national composite: if your practice books *N* appointments in a week and *D* of them DNA without enough notice to rebook, you lost *D* units of staffed capacity. The [no-show calculator](https://www.getarbol.com/tools/no-show-calculator/) exists to turn a local rate into a concrete weekly gap once you have your own denominator — not to replace NHS England’s published figures with a vendor estimate. ## Forgetfulness is not a personality flaw — it is an operations problem NHS England’s survey framing is operationally generous: people often have genuine reasons for missing or arriving late. The campaign still treats notification failure as recoverable. That is the create-need hinge. Practices that only count DNA after the fact are measuring the bruise. Practices that count confirmation, rearrange and late-cancel paths are measuring the collision before it happens. > “People will often have genuine reasons for not being able to make an appointment or arriving too late, but it’s really important that they let us know if possible so we can offer the appointment to someone else.” Fuente: NHS England, Tap the App campaign, March 2026 Two survey numbers deserve to sit on the same whiteboard as your DNA rate: **12% forgot**, **11% arrived too late**. They are not excuses to blame patients. They are design inputs. If a material share of missed care is memory or timing, then the control surface is reminder timing, channel reliability, and how hard it is to cancel or move a slot before the clinic day starts — not another poster about “respecting NHS time” alone. That is also why DNA belongs in the same conversation as evening and morning phone load. An unanswered rearrange request at 7:40 a.m. becomes a DNA at 10:15 a.m. The US-facing argument that unanswered after-hours demand quietly taxes the next day’s book — [after-hours calls as a practice cost](https://www.getarbol.com/en/blog/after-hours-calls-practice-cost/) — is a different legal and payment environment, but the operational sequence is familiar: contact failure upstream, empty slot downstream. ## How the national response landed The March 2026 campaign is not a new clinical pathway. It is a contact-behaviour push around the NHS App: turn on push alerts, cancel or rearrange through the app, keep contact details current, and use app prescription flows where available. NHS England stated the app has over **40 million** registered users. The policy bet is explicit — fewer forgotten appointments, more slots freed for someone else — not “hire your way out of DNA.” Public DNA signal → campaign response How the national framing moved in early 2026 2025 Activity up, DNA still large in absolute terms 376 million GP-practice appointments arranged; 16 million GP DNAs (4.3% / 1 in 23). Mar 2026 Tap the App campaign NHS England publishes the DNA and survey figures and urges notification opt-in plus in-app rearrange. May 2026 Monthly attendance snapshot NHS England Digital reports 89.6% attendance among appointments in general practice for May. Fuente: NHS England; NHS England Digital None of that replaces practice-level work. National campaigns move the median patient; they do not configure your reminder lead times, your DNA coding discipline, or your same-day rebook list. Commissioners and practice managers who treat the campaign as the entire answer will still wake up to empty rooms. Those who treat it as permission to tighten confirmation workflows will at least be measuring the right gap. ## What practices can do this month The goal is not to shame DNA rates into disappearance. It is to make non-attendance visible early enough that capacity can move. Local DNA discipline Turn national figures into a practice dashboard - Publish your own DNA rate beside NHS England’s 4.3% Same month, same denominator definition, same coding rules — national context, local ownership. - Split DNA reasons where your system allows Forgot / too late / transport / illness / unknown — survey shares only help if local coding can learn. - Measure rearrange latency, not only DNA count Hours of notice before a cancelled slot is the difference between rebookable capacity and a dead chair. - Align reminder timing with clinic risk High-DNA clinics and long-lead bookings need earlier and clearer confirmation paths than routine same-week slots. - Keep May’s 89.6% attendance labelled as May Do not average it with the 2025 annual DNA total into a synthetic ‘current rate’. - Pair DNA with phone abandonment Slots that never get booked never DNA — but they still leave unmet demand. See the access reading for that layer. A practice that already runs a tight book will feel DNA more, not less: every empty slot is a scarce clinician-hour. A practice drowning in demand will feel DNA as queue cruelty — someone else could have been seen. Either way, the create-need claim holds: if you are not measuring confirmation and early release, you are accepting a tax on capacity you already paid for. For product context around scheduling and proactive contact in English-speaking markets, start from [Arbol’s English home](https://www.getarbol.com/en/). For the appointment-volume side of the same England story, keep [NHS GP appointment access](https://www.getarbol.com/en/blog/nhs-gp-appointment-access/) open beside this page. When you have a local rate, stress-test the weekly gap with the [no-show calculator](https://www.getarbol.com/tools/no-show-calculator/). ## Frequently asked questions Frequently asked questions How many GP appointments did patients miss in 2025? NHS England reported that patients did not attend 16 million GP appointments in 2025, a DNA rate of 4.3% (1 in 23 appointments). What does the Tap the App survey say about why people miss appointments? In a Censuswide survey of 2,000 adults in England for NHS England, 12% said they had forgotten an appointment and 11% said they had arrived too late; nearly 1 in 4 said they had missed an NHS appointment because they forgot or arrived too late. Is May 2026’s 89.6% attendance the same as the 4.3% DNA rate? No. 89.6% is NHS England Digital’s attendance figure for appointments in general practice in May 2026. The 4.3% DNA rate is NHS England’s published figure for GP appointments across calendar year 2025. Cite them separately. Does reducing DNA create new clinical capacity? It recovers capacity that was already booked and staffed. It does not replace workforce expansion, but it stops paying twice — once to hold the slot, and again when the chair stays empty. Disclaimer This content is for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. ## Keep reading United Kingdom **Keep reading** United Kingdom Practice operations ### [NHS GP appointments: what the latest figures actually show](https://www.getarbol.com/en/blog/nhs-gp-appointment-access/) NHS England logged 30.0 million GP appointments in May 2026, 44.9% same-day. Here is how to read volume without mistaking it for phone capacity. Emilia Santander Jan 23, 2026 10 min read Read the article ### More to read United States Practice operations ### [After-hours calls are an invisible cost for US practices](https://www.getarbol.com/en/blog/after-hours-calls-practice-cost/) Evening and weekend phone demand rarely hits a dashboard. CMS access rules and MGMA polls show why that silent gap still taxes next week's schedule. Samuel Giraldo Jan 9, 2026 11 min read United Kingdom Practice operations ### [NHS 111 vs practice phone: where demand actually lands](https://www.getarbol.com/en/blog/nhs-111-vs-practice-phone/) NHS 111 routes urgent need; the practice phone still carries day-to-day access. Here is where each channel sits — and why an agent belongs on the practice line. David Lara Mar 27, 2026 10 min read United Kingdom Practice operations ### [NHS App booking limits: what practices actually control](https://www.getarbol.com/en/blog/nhs-app-booking-limits/) The NHS App can book GP appointments — until the practice turns booking off, embargos slots, or caps how many a patient may hold. Here is how those limits work. Emilia Santander May 1, 2026 10 min read ## Let’s look at your population in Arbol. A 30-minute video call with our team, using your cases: your contract, your patients and your channels. 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