A booking system that replaced three phone lines

Each clinic had its own phone number and its own paper appointment book. Patients could only book between 8:30 and 17:00, which is exactly when most of them were at work. Receptionists spent the first hour of every day returning voicemails.

Roughly one appointment in six ended in a no-show. Each empty 40-minute slot cost the clinic about £52, and with 1,900 appointments a month that added up to more than £16,000 of lost time every month.

Northfield had already tried an off-the-shelf booking product. It couldn’t handle clinicians who split their week between two sites, so staff kept both systems running in parallel and eventually went back to paper.

Priya spent two mornings at the reception desk in the Headingley clinic and Ingrid read through six months of the appointment book. Three things stood out.

• Most missed appointments weren’t forgotten; patients knew they couldn’t make it but didn’t want to sit on hold to cancel.
• Cancellations were rarely refilled, because by the time a receptionist had phoned around the slot had already passed.
• The clinic’s patient records system could export appointments but not accept them, so any new tool had to treat it as read-only.

That reframed the brief. The goal stopped being “online booking” and became “make cancelling as easy as not turning up.”

Booking that works at 22:00

Patients choose a treatment, a clinic and a time on any phone. Clinicians who work across two sites show up in both, with travel time between them blocked out automatically.

Reminders you can reply to

A text goes out 48 hours before each appointment. Replying C cancels it, replying R sends a link with the next three free slots. No app, no login, no hold music.

A waiting list that fills gaps

When a slot opens, the first three people on the waiting list for that clinician are offered it by text. The first to reply gets it; the others get a polite “someone beat you to it”.

One week, one screen

Receptionists see every clinician at every site for the week in a single grid, and can move an appointment by dragging it. The old paper book is now a printout for the fire box.

reminders/schedule.py1 deletion, 1 addition

31−send_reminder(appt, hours_before=24)

31+send_reminder(appt, hours_before=48, allow_reply=True)

Under the bonnet

A Next.js front end and a small Postgres-backed API, hosted in Northfield’s own cloud account in London. Appointments sync from the patient records system every five minutes. Text messages go through a UK gateway with delivery receipts, and every message a patient receives is logged against their record.