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’.

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.

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 and secondary 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. The strategy and supporting resources for health and social care can be found below.