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
Mapped the experience across roles to uncover visibility gaps and admin burden.
Through field visits, workflow observation, and user interviews, I mapped patient and staff journeys. Cancellations weren’t visible in clinical tools, lacked context, and led to manual chasing. These issues caused missed updates, wasted slots, and growing admin workload.
Field research · User interviews · Experience mapping
Framing the right fix
Defined scope and priorities to align design, product, and engineering.
I led planning to identify feasible gaps to solve within platform and capacity constraints. I prioritised visibility, workflow fit, and reduced follow-up effort. Key decisions were captured in a Design Goals document shared across product, engineering, and leadership.
Design strategy · UX prioritisation · Stakeholder alignment
Designing for clarity
Prototyped and tested flows focused on visibility and usability.
I defined what to show, when to notify, and how to capture input. I tested early concepts with the clinical team and iterated based on feedback from them and internal stakeholders. For example, I refined cancellation reason inputs after staff flagged potential patient confusion.
Product design · User journey mapping · Prototyping
From design to release
Supported implementation to maintain intent and ensure consistency.
I worked closely with engineers to clarify logic, handle edge cases, and adapt specs as constraints emerged. I supported QA and rollout to ensure consistency across integrated and non-integrated services.
Design systems · Engineering handover · QA
Condensed change impact flow across levels
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 appear directly in the Accurx Inbox, where clinical teams already manage patient communication. Each update includes appointment details and any patient-provided reason, helping staff act quickly with the right context.
This solution addressed a key gap identified during discovery. Cancellations were not visible in tools clinicians use day to day. I worked with engineers to define the data model, behaviour, and edge cases that shaped how and when updates are shown.
Surfacing appointment changes in Accurx Inbox
Guiding patients with clarity
The redesigned cancellation flow guides patients through the process with clearer steps and realistic expectations. Although SMS content remained fixed, the interface now sets appropriate context and prompts patients to explain why they are cancelling or want to rebook an appointment.
This improved clarity and reduced back-and-forth, addressing the goal of minimising unnecessary follow-up. Patient inputs now appear in the Inbox, helping clinical teams triage faster.
Key updates to the patient flow
Putting teams in control
I improved the configuration system to give services more control over how reminders and cancellations are managed. New options allowed teams to define which appointments could be cancelled, who could cancel them, and when those options expire.
These improvements ensured patients only saw relevant actions, and staff received requests they could safely act on. The setup now supports both integrated and non-integrated services and enables safe, flexible rollout across different care settings, including NHS Trusts.
New configurations for reminder set up
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