Reducing No-Shows Through Smarter Appointment Amendments

Reducing No-Shows Through Smarter Appointment Amendments

Reducing No-Shows Through Smarter Appointment Amendments

Overview

Appointment Reminders helps NHS services reduce missed appointments by letting patients cancel or request changes via text. While widely used, the experience lacked flexibility and visibility. Cancellations were not surfaced to clinicians, settings were inflexible, and the patient flow often caused confusion.

I redesigned the experience across clinician and patient journeys, introducing clearer flows and configurable options for timing and content. I worked with cross-functional teams to align the solution with workflows, platform constraints, and accessibility. The changes led to a 50% drop in missed appointments, a 60% increase in reminder usage, and over 270,000 cancellations with patient-provided reasons, showing the feature is widely used and trusted.

Date

Date

2024

2024

Company

Company

Accurx

Accurx

Platform

Platform

Platform

Responsive web, Desktop app

Responsive web, Desktop app

Responsive web, Desktop app

Team

Team

Team

Cross-functional team (Design, Research, Product, Engineering)

Cross-functional team (Design, Research, Product, Engineering)

Cross-functional team (Design, Research, Product, Engineering)

Redesigned appointment experience for clinicians and patients

Redesigned appointment experience for clinicians and patients

What wasn’t working

Appointment Reminders let patients cancel appointments, but clinicians weren’t alerted when this happened. Cancellations didn’t appear in clinical calendars or the Accurx Inbox, so updates were often missed, leading to wasted slots, delayed care, and manual work. This lack of visibility and flexibility created real problems for teams using the product:

“We don’t know when they’ve cancelled. There’s no time when they cancel, there’s nothing. Every hour, people were having to check that we’ve not got any cancelled appointments... because we’ve got no way of knowing.”

— Service Pathway Coordinator, Community Trust

The product was also rigid. Clinicians couldn’t adjust how reminders or cancellations behaved, which made the experience hard to trust and difficult to scale across NHS Trusts. Legacy logic and platform changes introduced inconsistencies in how reminders were sent, tracked, and actioned by clinical teams.

As part of a wider product redesign, I owned the design for Appointment Reminders and worked closely with other teams to ensure alignment across features and platform changes.

My approach and methods

I took an end-to-end approach to improve how cancellations were managed across clinical workflows, facilitating workshops throughout to align teams, shape direction, and stress-test ideas.

  1. Uncovering the gaps

I partnered with our researcher on field visits, workflow observation, and interviews to map patient and staff journeys. We found that cancellations lacked visibility and context, leading to missed updates, wasted slots, and admin burden.

User research · Interviews · UX mapping

Example of EMR setup where clinicians had to manually monitor cancellations

Reframed issues into opportunities

  1. Framing the right fix

I partnered with our PM and researcher to identify high-impact opportunities that aligned with platform and capacity constraints. We prioritised visibility, workflow fit, and reduced follow-up effort. I documented our direction in a Design Goals doc to align product, engineering, and leadership.

Problem framing · UX scoping · Alignment

  1. Designing for clarity

I defined what to show, when to notify, and how to capture input across clinician tools and patient flows. Tested with clinicians and iterated based on feedback — including refining cancellation reasons to reduce confusion and improve communication.

Product design · UX mapping · Prototyping

Clinician solution example

Example of documentation of new Logic

  1. From design to release

I collaborated with engineers to clarify logic, refine specs, and handle edge cases as constraints arose. I supported Design Assurance and rollout to maintain consistency across integrated and non-integrated services.

Design systems · Engineering handover

Key improvements

I focused on three key improvements to make appointment changes more visible, manageable, and flexible: improving trust for clinicians, clarity for patients, and control for services.

Bringing visibility into clinical workflows

Appointment changes now surface in the Accurx Inbox, where clinical teams manage patient communication. Each update includes appointment details and patient-provided reasons, helping staff respond with the right context. This addressed a key gap: cancellations weren’t visible in everyday tools. I worked with engineers to define the data model, behaviours, and edge cases that determine how and when updates appear.

Surfacing appointment changes in Accurx Inbox

Guiding patients with clarity

The redesigned flow set clearer steps and realistic expectations, prompting patients to explain cancellations or request rebooking. While SMS content remained fixed, the interface provided better context. This reduced back-and-forth and helped clinical teams triage faster by surfacing patient inputs directly in the Inbox.

Key updates to the patient flow

Putting teams in control

The updated configuration system gave teams more control over how reminders and cancellations were managed. They could now define which appointments could be cancelled, by whom, and when those options expired. This helped ensure patients only saw relevant actions and staff received requests they could safely act on, supporting safer rollout across integrated and non-integrated services including Trusts.

New configurations for reminder set up

The impact

🩺 Clinicians gained control and clarity

Custom reminder settings increased volume by ~60% with no extra admin, while surfacing cancellations in the Inbox made them faster to action.

📲 Clearer flows, faster triage

Over 270K cancellations now capture patient reasons, enabling faster triage and reducing unnecessary follow-ups.

📉 Fewer missed appointments

Clearer flows and timely updates cut Do Not Attend appointments by up to ~50% in Pilot Trusts

The impact

🩺 Clinicians gained control and clarity

Custom reminder settings increased volume by 60% with no extra admin, while surfacing cancellations in the Inbox made them faster to action.

📲 Clearer flows, faster triage

Over 270K cancellations now capture patient reasons, enabling faster triage and reducing unnecessary follow-ups.

📉 Fewer missed appointments

Clearer flows and timely updates cut Do Not Attend appointments by up to ~50% in Pilot Trusts

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Let’s build something impactful!

I’m always excited to collaborate on innovative and exciting projects! 😊

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Let’s build something impactful!

I’m always excited to collaborate on innovative and exciting projects! 😊

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uxd.lena・©2025

uxd.lena・©2025

uxd.lena・©2025