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

Team

Team

1 Product designer (me)

1 Product designer (me)

1 Design lead

1 Design lead

1 Product manager

1 Product manager

1 Sr. User Researcher

1 Sr. User Researcher

6 Engineers

6 Engineers

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

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

  1. 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

  1. 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

  1. 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

Synthesised issues and reframed into design opportunities

Insights shaped into opportunities

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

The impact

🩺 Clinicians gained control and clarity

New configuration options allowed clinicians to control when and how reminders were sent, tailoring timing to service needs.
→ Led to a 60% increase in reminder volume, without adding admin burden.

Cancellations were also surfaced in the Inbox, a deliberate design choice to reduce missed updates and make changes easier to action.

📲 Clearer flows, faster triage

The redesigned flow made it easier for patients to cancel or request changes, with clearer steps and more realistic expectations.

→ Over 270,000 cancellations included patient-provided reasons.
→ Helped clinicians triage faster and reduced unnecessary follow-up.

📉 Reduction in missed appointments

Missed appointments remain a critical challenge across the NHS, with major impact on care delivery and system efficiency.

→ Smarter reminder timing, clearer flows, and better visibility contributed to up to a 50% reduction in DNAs (Did Not Attend) across some services — a significant improvement on one of the NHS’s most persistent problems.

The impact

60% increase in reminders
📈

More reminder messages sent, helping services reach patients earlier and more reliably.

270,000+ cancellations with reasons
💬

Patient-provided reasons helped staff triage more efficiently and avoid unnecessary calls.

Up to 50% reduction in missed appointments
📉

Smarter reminder timing, clearer flows, and improved visibility helped reduce missed appointments.

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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