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How EMMA Handles Calls When Medical Capacity is Reached

Purpose of Document

Practices frequently contact support to ask why patients are being told the surgery is at capacity, why certain calls are still going through after capacity is reached, or why patients are receiving 111 or 999 signposting. This article ensures all support staff can explain EMMA's capacity behaviour accurately, confidently, and in line with NHS contract requirements.

Background: What the Medical Capacity Cap Is

The medical capacity cap is the only cap that should be placed on EMMA. It controls how many clinical requests EMMA accepts per day.

This is the mechanism that allows practices to manage same-day clinical demand in a controlled and safe way, in line with NHS guidelines that permit safeguards to prevent overwhelming clinical triage capacity.

The cap is set directly within the practice's online consultation tool (for example Accurx, eConsult, Klinik) and not through EMMA or the QuantumLoop dashboard. EMMA reads the cap from the consultation tool and responds accordingly. Adjusting the cap does not require any action from the QuantumLoop team.

Important: the medical cap is the only form that can be capped or switched off. Admin and routine forms cannot be capped and must remain on at all times. If admin or routine forms are switched off, EMMA disables herself automatically as a fail-safe.

How EMMA Behaves When Medical Capacity is Reached

The following table covers every scenario a support team member may encounter.

Scenario What EMMA Does
Patient calls with a new medical concern EMMA informs the patient the practice has reached its capacity for same-day medical requests. She advises the patient to call 111 if the matter is urgent, or 999 in an emergency. She then offers the option to submit a routine appointment request for non-urgent matters.
Patient confirms non-urgent and is happy to wait The call continues through the routine appointment flow. The request is submitted as a routine appointment for the practice to review and schedule, typically within 24 hours. This is compliant with the GP contract requirement that non-urgent appointment requests remain available throughout core hours.
Patient is insistent and wants to speak to someone EMMA transfers the patient directly to the surgery bypass number. Patients who feel their matter is urgent can always reach a human, regardless of capacity.
Emergency red flag detected regardless of capacity EMMA advises the patient to call 111 or 999 depending on severity. If the patient insists on speaking to surgery staff, EMMA bypasses all transfer rules and transfers the call directly to the surgery. Clinical safety always takes priority over capacity limits.
EMMA is already mid-call when capacity is reached EMMA completes the call and submits the request. EMMA will never abandon a call already in progress. If the online form has been switched off before the call finishes, EMMA submits the details via email to the fallback email address provided during onboarding.
Admin or routine request, not medical Completely unaffected. Admin and routine forms are not subject to the medical cap and remain open at all times.

Key Points to Communicate to Practices

1. Patients are never turned away without a safe next step

Every patient who calls when capacity is reached receives either a safe signposting message (111 or 999), a route to submit a routine request, or a transfer to reception. No patient is ever told to simply hang up.

2. Emergency calls always go through regardless of capacity

Red flag and emergency calls bypass the medical cap completely. EMMA's clinical safety logic is not affected by capacity settings.

3. Admin and routine calls are completely unaffected

Capacity limits only apply to medical requests. Fit notes, test results, referral chasing, prescription queries, blood test bookings, smear tests, and all other admin and routine calls continue to be processed as normal.

4. The cap is set in the consultation tool, not by QuantumLoop

Practices control their own medical cap directly within their consultation tool. QuantumLoop does not set or adjust this cap. If a practice wants to increase or decrease their cap, they do this themselves within their consultation tool. EMMA will automatically read the updated number.

5. The cap resets daily

The cap resets each day based on the settings in the consultation tool, typically aligned with the surgery's opening hours.

Recommended Cap Setting

Practices should set their daily medical cap slightly below their absolute maximum. This is because EMMA may already be mid-call with a patient when the cap is reached. Building in a small buffer ensures in-progress calls can still be submitted without exceeding the team's triage capacity.

For example: if a team can comfortably triage 50 medical requests per day, set the cap at 45 to 48.

Known Platform Issues Related to Capacity

Anima surgeries: certain capacity states were not detected (resolved April 2026)

Before 30 April 2026, certain capacity reached states in Anima were not recognised by the system. EMMA could incorrectly assume a surgery was available and submit forms when capacity had actually been reached. This required manual admin intervention to manage incorrectly submitted forms.

This was resolved on 30 April 2026. All capacity reached states are now correctly detected across Anima surgeries and no forms are submitted when capacity has been reached.

What to do if an Anima surgery reports this after 30 April 2026:

  • Confirm the date of the affected submissions
  • If after 30 April 2026, escalate to engineering with the surgery ODS code and affected enquiry IDs

System Connect surgeries: false capacity alerts at surgery start time (resolved April 2026)

Before 28 April 2026, capacity checks for System Connect surgeries could fire within seconds of a surgery's scheduled start time. Because System Connect was not always fully active at the exact start time, the capacity check could misread the status and incorrectly show the surgery as having reached capacity before any patients had been seen.

This was resolved on 28 April 2026. Capacity checks are now briefly delayed after each System Connect surgery's scheduled start time, allowing the system to fully activate before checks begin.

What to do if a System Connect surgery reports this after 28 April 2026:

  • Confirm the time of the affected calls
  • If occurring at the surgery's scheduled start time and after 28 April 2026, escalate to engineering with the surgery ODS code and affected call timestamps

Step-by-Step Triage Process

  1. Ask the practice to describe what they are seeing or what patients are reporting. Are patients being told they cannot submit a medical request? Are emergency patients being directed to 111 or 999? Are calls going through after the practice believed capacity was reached?
  2. Confirm the practice's consultation tool.
  3. Check what the current medical cap is set to in the consultation tool.
  4. Confirm whether the affected calls were medical, admin, or routine in nature.
  5. If the issue relates to Anima or System Connect, check whether it predates the April 2026 fixes.
  6. If no configuration issue is found and the behaviour is not matching what is described in this article, escalate to engineering.

What to Tell the Practice

Keep communication clear and reassuring. Example wording for a practice questioning why patients are being told capacity is reached:

"When EMMA tells a patient the surgery has reached its capacity for same-day medical requests, she always provides a safe next step. Urgent patients are directed to 111 or 999, and patients who are happy to wait are offered a routine appointment request. Emergency calls always go directly to reception regardless of capacity. Admin and routine calls are completely unaffected. The cap itself is set within your consultation tool and you can adjust it there at any time."

Common Mistakes

  • Telling a practice that QuantumLoop sets or controls the medical cap. The practice sets this directly in their consultation tool.
  • Assuming emergency calls are blocked by the capacity cap. They are never blocked.
  • Confusing the medical cap with the admin or routine forms. Admin and routine cannot be capped.
  • Not checking whether an Anima or System Connect surgery is affected by the pre-April 2026 capacity detection issues.
  • Treating capacity-reached behaviour as a fault when it is working exactly as designed.

Escalation Guidance

Escalate to engineering if:

  • EMMA is submitting medical forms after the cap has been confirmed reached and the consultation tool is Anima, and the incident postdates 30 April 2026
  • EMMA is showing capacity reached at the surgery's start time for a System Connect surgery and the incident postdates 28 April 2026
  • Emergency calls are not bypassing the medical cap and are not being transferred to reception
  • Admin or routine calls are being blocked unexpectedly
  • The capacity cap behaviour cannot be explained by any scenario in this article

When escalating, always include:

  • Surgery name and ODS code
  • Consultation tool used
  • Description of the behaviour observed
  • Affected call IDs or timestamps
  • Current cap setting in the consultation tool if known

Last Reviewed: May 2026 Owner: Support and Customer Success