{
  "abstract": "Background As the counselling service at Harlington Hospice has expanded with trainees and counsellors, the number of clients seeking support has also increased. However, this growth has brought higher rates of non-attendance for initial assessments. This includes clients’ non-engagement, not attending, and cancelling in advance but still not engaging. Non-attendance reduces access for others and contributes to longer waiting times. This underscores the need to understand the nature and course of grief, and to respond with a supportive rather than punitive approach. It is also necessary to assess whether referrals are appropriate. If clients feel obliged to attend, it may affect their motivation or ability to engage.Aims Identify patterns in non-attendance linked to referrals, such as: geographical location, deprivation levels, socioeconomic and identity.Strengthen partnerships with referrers.Reduce service costs.Decrease waiting times.Improve referrer understanding of the service.Reduce barriers to attendance.Methods Using data from an independent evaluation, all cancellations over a 15-month period were reviewed. Analysis focused on demographic, clinical, and service-related predictors of non-attendance. A quantitative survey was also conducted to evaluate the impact of service interventions.Results GPs and healthcare providers had the highest rates of cancellations. Most non-attenders came from mid-range deprivation areas and travelled 30-60 minutes. Improvements such as cancellation guidelines, better communication, appointment cards, and online sessions contributed to better attendance. By implementing key learnings, the service achieved a 58.6% reduction in cancellations over a five-month period. However, cancellation rates remain variable, influenced by factors such as weather conditions, illness, and holidays.Conclusions Non-attendance was more common among clients referred by professionals than among those who self-referred. A review of referral criteria and communication is planned. Drawing on the findings of Binnie and Boden (Ment Health Rev J. 2016;21(3):231–248), visual prompts thanking clients for attending will be introduced in all waiting areas to help reinforce engagement.",
  "authors": [
    {
      "affiliations": [
        "Harlington Hospice, London, UK"
      ],
      "name": "Debra Morgan"
    },
    {
      "affiliations": [
        "Metanoia Institute, London, UK"
      ],
      "name": "Deborah Lee Miller"
    }
  ],
  "title": "P-44 Thank you! Attending your appointment today matters, for you and for others waiting",
  "uid": "ba43f052-d753-595a-828d-bd9d669dbe20"
}