Prevention of Adult Not Brought Strategy

Health services are continually aiming to reduce the number of appointments that are unattended. In current times when waiting lists are high, minimising the number of clinical hours lost because a person did not attend their appointment has become even more important.

In some cases people may choose not to attend health appointments and stop their contact from health services. In other circumstances people rely on family or care providers to bring them to appointments.

Historically Did Not Attend has been the only code available to use to record when an appointment was missed by an adult. However, this is neither appropriate nor accurate when describing adults who cannot attend because they do not have the capacity or capability to attend. In these situations, the adults are not brought should be marked and reasonable adjustments made and documented to ensure they can attend. The same questions should be asked in the situation with vulnerable adults as with children not brought.

A code has now been developed and rolled out into clinical systems, ‘adult not brought to appointment’. Currently the code is not being widely used.

Led by Dr Kathy Petersen Clinical lead for Learning Disability, Autism, Children and Mental Health for Northumberland place within the North East North Cumbria Integrated Care Board and in partnership with the North East & Cumbria Learning Disability Network, a Prevention of Adult Not Brought strategy and toolkit has been developed.

The strategy looks to:

  1. Raise awareness of the adult not brought code and increase usage
  2. Raise awareness of reasonable adjustments
  3. Support services to identify those at risk of not being brought to appointments and mitigating risks
  4. Improving whole workforce education in relation to reasonable adjustments
  5. Link with the national reasonable adjustment flag and Learning Disability Autism Awareness Training

Alongside the strategy a range of resources have been developed to support staff working in health and social care. These include:

  • Reasonable Adjustment Campaign
  • Workforce education package for primary & secondary care
  • Workforce education package for social care
  • Resources promoting reasonable adjustments for professionals and people with learning disabilities and families
  • Top tips for primary & secondary care
  • A risk concern tool

The strategy focuses on adults with a learning disability who are at risk not being brought however the principles can apply to all vulnerable adults and those who find it hard to access services including:

  • People with severe mental illness or a multiple complex needs presentation
  • Those suffering with frailty
  • Those with dementia
  • Those experiencing domestic abuse
  • Those without English as a first language
  • Sight loss and or hearing loss
  • Vulnerable adults
  • Those at risk of lack of capacity or fluctuating capacity
  • Those under 18’s but over 16’s who have the right to make their own decisions

The strategy has been developed as a supporting tool for primary care services to think about and implement the principles within the prevention of adult not brought and wider reasonable adjustments work. It can be adapted and localised to fit with local practice. The strategy and supporting resources for health and social care can be found below.


Prevention of Adult Not Brought Resources