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.
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.
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
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
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
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
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