Government interest in health service "did not attend" (DNA) rates was seen to occur by accident, following which efforts to reduce DNAs have tended to concentrate on operational rather than strategic issues. Considers the effect hospital culture has had on DNA rates from an organizational and patient perspective. Identifies some of the key cultural issues that impacted on DNA rates by utilizing observation and telephone survey research methods. Concludes that, in the main, the lack of customer-oriented organizational culture was seen to affect DNA rates adversely within one NHS provider trust.