How EMMA Handles Calls About Appointments: Late Arrivals, Cancellations, and Changes

Purpose of Document

Appointment-related calls are a significant proportion of daily call volume at most surgeries. How EMMA handles these calls is one of the most frequently configured aspects of the platform. This article is the companion to Article 10 (EMMA is Not Routing Appointment Calls to Reception) and provides the complete reference for how appointment handling works, including the default flow, surgery-specific configurations already in place, and what is coming next in V12 Pathways.

What EMMA Can and Cannot Do With Appointments

Before explaining the handling flow, support staff must be clear on EMMA's fundamental capabilities.

EMMA cannot:

• Book a new GP or nurse appointment directly in the clinical system
• Cancel an existing appointment in the clinical system
• Confirm whether an appointment exists in the clinical system
• Access the appointment book in real time

EMMA can:

• Transfer the caller directly to reception for any appointment action
• Ask a clarifying question when a patient says they are calling about an appointment without specifying what they need
• Signpost patients to the NHS App to manage appointments (cancellation via Pathways is coming in a future V12 release)
• Be configured per surgery to route specific appointment call types directly to reception without any deflection steps

Default Appointment Call Handling Behaviour

By default, how EMMA handles an appointment call depends on the surgery's transfer sensitivity level and whether the patient states their appointment intent clearly.

When the patient clearly states their appointment intent:

When the patient's appointment intent is vague:

If a patient says "it's about an appointment" or "it's regarding an appointment" without specifying what they need, EMMA asks a clarifying question before routing:

"Do you want to book, cancel, confirm, or change an appointment?"

This prevents premature or incorrect transfers and ensures the call is routed to the correct destination.

Surgery-Specific Appointment Routing Configurations

Several surgeries already have custom appointment routing configured. Support staff must check the surgery's configuration before advising on expected behaviour.

Purbeck Health Centre (February 2025) EMMA immediately transfers callers to reception for the following actions without any deflection steps:

• Confirming an appointment
• Moving, changing, rebooking, or rescheduling an appointment
• Cancelling an appointment

If a caller says "it's regarding an appointment" without specifying an action, EMMA asks the clarifying question before routing. This configuration applies to Purbeck Health Centre only (ODS code K82027).

Newgate Surgery Appointment cancellation and rescheduling configured as immediate transfer to reception. No deflection steps applied to these call types.

West Meads Surgery Immediate routing to reception for appointment-related and test-related calls.

Woodingdean Surgery Remote and extended hours appointment requests routed to reception. Nurse and GP booking requests have dedicated routing configured.

Other surgeries continue to use their default appointment routing flows unless a configuration change has been requested and applied.

Running Late Calls: A Time-Sensitive Scenario

Running late calls are time-critical. If a patient calls to say they are running late and the call goes through multiple deflection steps before reaching reception, the patient may miss their appointment entirely by the time the transfer completes.

EMMA can be configured to transfer running late calls immediately to reception without any deflection steps. This is recommended for practices where appointment punctuality is operationally important.

If a practice complains that running late callers are not reaching reception fast enough, raise a configuration request to add running late calls to the immediate transfer bypass list for that surgery.

Appointment Cancellations via Pathways (V12 Roadmap)

As of EMMA V12 (May 2026), appointment cancellations are listed as a coming next feature within the Pathways feature set.

When this is released, EMMA will be able to handle appointment cancellations directly through Pathways by routing the patient to the NHS App via a secure deep link sent by SMS. The patient can cancel their appointment directly in the NHS App without needing to speak to reception.

This will follow the same intelligent fallback chain as repeat prescriptions:

• NHS App deep link sent by SMS as the first option
• Fallback to SOPHIA, the practice website, or reception if the patient cannot use the NHS App
• Full per-practice configuration so EMMA handles cancellations the way each surgery prefers

This feature is not yet live at the time of this article. It will be documented fully when released. In the meantime, appointment cancellations are handled by transferring to reception.

Handling the "EMMA Cannot Book Appointments" Objection

Some practices are disappointed that EMMA cannot book appointments directly. This is one of the most commonly raised objections during sales and onboarding.

The accurate response is:

EMMA is a request capture and routing system. She captures what patients need and routes them to the right place. Direct appointment booking would require integration with the clinical system's appointment book, which varies significantly across EMIS, SystmOne, and other systems. This integration is not currently available.

For appointment booking, EMMA redirects patients to the NHS App or online booking system, or transfers to reception. Future Pathways releases will extend EMMA's ability to handle appointment cancellations via the NHS App without needing reception involvement.

Step-by-Step Triage Process

When a practice raises a complaint about appointment call handling:

1. Ask the practice to describe the specific scenario. Running late? Cancellation? Rebook? Confirmation? New booking?
2. Confirm the surgery's current appointment routing configuration.
3. If the complaint is about calls going through too many deflection steps, discuss whether immediate transfer should be configured for those specific call types.
4. If the complaint is about running late calls not reaching reception fast enough, recommend adding running late calls to the immediate bypass list.
5. If EMMA is not routing correctly despite a configuration being in place, review the call recording to confirm what the patient said and how EMMA responded.
6. If the configuration is confirmed correct and EMMA is still routing incorrectly, escalate to engineering with the call ID and surgery ODS code.

What to Tell the Practice

Example wording explaining default appointment handling:

"By default, EMMA handles appointment calls based on what the patient tells her. If a patient is specific about what they need, such as saying they want to cancel or that they are running late, EMMA routes the call accordingly. If the patient is vague, EMMA asks a quick clarifying question before routing. We can configure your surgery so that specific appointment call types, such as cancellations, running late, and rescheduling, are transferred to reception immediately without any questions. Would you like us to set that up?"

Example wording explaining what EMMA cannot do:

"EMMA is not able to book appointments directly into the clinical system or cancel existing appointments within the system. When a patient calls about an appointment, EMMA transfers them to your reception team or directs them to the NHS App depending on your configuration. A future release will allow appointment cancellations to be handled through the NHS App directly, without needing reception involvement."

Common Mistakes

• Telling a practice that immediate appointment transfer cannot be configured. It can, and several surgeries have it configured already.
• Not checking the surgery's current appointment routing configuration before advising on expected behaviour.
• Telling a practice that EMMA will soon be able to book appointments directly. She will not. Only appointment cancellations via the NHS App are on the roadmap.
• Not raising a configuration change request when a practice asks for running late calls to reach reception faster.
• Treating appointment routing behaviour as a platform fault without first checking the configuration.

Escalation Guidance

Escalate to engineering if:

• A configuration has been applied for immediate appointment transfer but EMMA is still routing through deflection steps after 48 hours
• EMMA is routing appointment calls incorrectly even when the patient's intent is clearly stated
• The clarifying question is not appearing when it should for vague appointment calls

When escalating, always include:

• Surgery name and ODS code
• Appointment call type affected (running late, cancellation, rebook, confirmation)
• Current configuration in place for that surgery
• Call ID and timestamp for the affected call
• Description of what the patient said and how EMMA responded

Last Reviewed: May 2026 Owner: Support and Customer Success