Lost to the System #2 - Exploring the reasons why people leave a service

by Stuart Stokes on February 20, 2017

In our previous post we examined the reasons why people decided to decline the offer of a public health intervention.

 This post focuses on the reasons why people leave a service before completion. 

Understanding the reasons why people leave a service is crucial to the overall success of your service. If a person does not complete the intervention the chance for collecting data and outcomes declines and may have a negative impact on key performance indicators.

The reasons may be linked to the content of your programme, the ability of staff to maintain motivation or other reasons worth exploring.


The sample

We took 21,342 records from the ReferAll system for referrals that had been classified as 'Left Early'. We focus on the term 'left early' as opposed to drop out but for many they mean the same. We analysed the reasons for Left Early across all 161 services and then grouped the reasons into linked themes.

The themes chosen were:

  • Change in medical status - either the client was feeling unwell, developed a new condition or felt for medical reasons they could not continue
  • Cost/Time/Location - Either one of these reasons have become an issue to the client at some point in the service
  • Goals/needs met - the client no longer needed the service as they have achieved their intended outcome
  • Low attendance - low attendance, where a scheme may restrict participation on attendance or simply stopping
  • Unsuitable - client deemed unsuitable for the service once they had commenced
  • Other commitments - such as family, work and social has interfered with their participation
  • Unable to contact - low attendance was noticed but when Scheme Administrators attempted to contact they were unable
  • Other - all other reasons that do not fit into the themes above


Of the 21,342 records analysed and then grouped the most occurring reason was 'Other' (56%). The next most popular reason was 'Low Attendance' (26%).

Further information can be seen in the graph below



As with our previous post it is interesting to note that the majority of Scheme Administrators when selecting a reason for Left Early chose other. We strongly recommend that greater variability is offered when selecting a reason. Without the reason behind the state action cannot be undertaken.

Some of the themes cited above need further understanding. For example, if a person's attendance is variable what methods could be deployed to increase motivation throughout the service?

If a person cannot be reached for contact what methods can be deployed when the person commences to ensure that their contact details are correct and up to date?


Read more

Download our free Lost to the System guide by clicking the image below.

New Call-to-action

Topics: Referral Schemes