If you’re working in the field of Social Prescribing and seeing clients, you may have had days or even weeks where some or many people don’t show up. One piece of research has suggested that deprivation is the biggest driver of missed GP appointments (Lancet, Dec ’17) so it makes sense that Social Prescribing clients can sometimes be difficult to engage.
Here are 5 ideas that have helped me boost client attendance so that more people can benefit from our service
1) The telephone; it’s how you use it! It’s likely your first contact with the client will be on the phone. Here are some tips that have helped me to engage with my clients successfully. Getting hold of a client: Some people don’t answer unknown numbers, so you can text ahead to introduce yourself then call shortly after, or leave a voicemail or text asking them to get back to you (texting seems to trump voicemail nowadays!). OK, maybe this sounds too obvious, but it can be a tricky business! Ask: “Do you think a face to face appointment would be useful for you?” Ask this rather than going straight ahead and booking them in for an appointment they may not really be committed to attending. Telephone signposting: If your client’s needs are clear then simply assist them over the phone with the information they need to save time for both of you. Telephone appointments: These are great if your client has certain barriers (see point 2). Timing is everything: Use the information you have about the client to judge when might be the best time to first call. Maybe they are busy because of school runs or work or they are retired or unemployed. For me, overall I find more people answer late morning!
2) Discuss your client’s barriers. Our clients can feel that lots of things are holding them back, which is partly why they are seeking support (or the GP has recommended it). These barriers may stop them at the first hurdle from even attending a social prescribing appointment. Try to find a time, place and type of appointment that best suits your client (as far as you have the resources). Are they a morning person? They can have the 9am slot! Are they afraid of busy waiting rooms? Find out the least busy time for the practice (if practice based). Do they have a school run to do? Do they work 9–5pm or nights? Are they afraid of leaving the house? Do they have a bus to catch which is better at a certain time of day? Does that cost them money? Are they a carer? All of these factors might mean that someone misses an appointment or disengages completely, so be frank and try to get a sense of these within your first appointment with your client
3) Text an appointment reminder the day before. Sounds simple and many of you probably already do this, because often people forget or haven’t written down their appointments, but I’ve found that wording the message to promote accountability can actually make a difference! For example, I used to write something like ‘Hi ……just a quick reminder of your appointment tomorrow at 2pm at …..Surgery, Best wishes, Will’ and now I write ‘Hi….appointment confirmed for tomorrow at 2pm at ….Surgery. See you tomorrow. Will’. Perhaps the first one is too casual but since using the second one, fewer clients have texted me back to say ‘Sorry I can’t make it’ and more have attended, I think because it sounds more formal. So if you’re getting lots of no shows, try playing with your wording!
4) Sense your client’s commitment. After the first appointment, I always try to ask the client two questions. “Was that helpful today?” and “Would it be useful for you to have another appointment?” Of course, I also say what I think might be useful for them but it’s a joint decision. If you sense the client is being polite or hesitant and just re-booking because they think they should, then try to be open and say that it really is only if they think it would help them. After the first appointment they may still not be quite ready to get support or set goals, or it may not be for them.
5) Book short and long slots. I used to book 45 minute slots for all of my clients, but then if one doesn’t arrive that’s a lot of time wasted. Now I book 20 minute slots and 45 minute slots. The shorter slots work well for follow ups and more regular clients and the longer ones for new clients. I also ask the client which length of appointment they would prefer. This means I can book more clients in per day and if any don’t show up then it’s not as much of a problem.
Of course, managing our client case-loads is a bit of an art and it depends on the types of clients you’d like to engage. Here in Bristol, we are working in the areas of deprivation as part of a citywide Public Health backed project. I hope that in sharing my experiences you’ve picked up something useful and would love to hear your thoughts, ideas and best practice
Social Prescribing Link Worker Southmead Development Trust