EMMA is Not Routing Appointment Calls to Reception

Purpose of Document

Practices regularly raise complaints that EMMA is not sending appointment-related calls to reception correctly. This is one of the most common objections listed in the internal Objections and Response Playbook. Patients calling to cancel, rebook, confirm, or say they are running late for an appointment often expect to be transferred to reception immediately. If EMMA handles this through deflection steps instead, it creates frustration and the practice perceives it as a failure. Staff must understand how appointment routing works, when it is configurable, and how to set the right expectation with the practice.

Background: What EMMA Can and Cannot Do With Appointments

Before triaging any appointment routing complaint, staff must be clear on EMMA's fundamental capabilities around appointments.

EMMA cannot:

• Book a GP appointment directly
• Book a nurse appointment directly
• Cancel or update an existing appointment in the clinical system
• Access the practice's appointment book in real time

EMMA can:

• Redirect patients to the NHS App to self-manage appointments including cancellations
• Transfer the call directly to reception for same-day or time-sensitive appointment changes
• Ask a clarifying question if a patient says they are calling about an appointment without specifying what they need
• Be configured per surgery to immediately transfer appointment-related calls to reception without any deflection steps

As of EMMA V12 (May 2026), appointment cancellations are listed as a coming next feature within the Pathways feature set. This means in a future release, EMMA will be able to handle appointment cancellations directly through Pathways, routing the patient to the NHS App to cancel without needing to speak to reception. This is not yet live at the time of this article and will be documented separately when released.

How Appointment Routing Works by Default

By default, EMMA's handling of appointment-related calls depends on how the patient phrases their request and the surgery's transfer sensitivity level.

The key scenarios are:

Surgery-Specific Appointment Routing Configuration

Appointment routing behaviour can be fully configured per surgery. Several surgeries already have custom appointment routing in place based on their specific preferences.

Examples from existing configurations:

Purbeck Health Centre (February 2026): configured for immediate transfer to reception for all appointment confirmation, change, rebook, and cancellation requests. No deflection steps. If the patient says "it's about an appointment" without specifying, EMMA asks one clarifying question before routing.

Newgate Surgery (January 2026): appointment cancellation and rescheduling configured as immediate transfer. No deflection applied to these call types.

Woodingdean Medical Centre: remote and extended hours appointment requests routed to reception. Nurse and GP booking requests also have dedicated routing configured.

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

These are surgery-specific configurations. Other surgeries continue to use their default appointment routing flows unless a configuration change has been requested.

Common Causes and What to Check

1. The surgery's appointment routing has not been configured for immediate transfer

This is the most common cause. The surgery is on a default configuration where appointment calls go through transfer sensitivity deflection steps rather than routing immediately to reception.

What to do:

• Confirm what the practice wants: do they want all appointment-related calls to transfer immediately to reception, or only specific types such as cancellations and running late calls?
• Raise a configuration change request specifying the exact routing logic required
• Provide the surgery name, ODS code, and the specific call types that should trigger an immediate transfer
• Confirm with the practice once the change is live and ask them to monitor for 24 to 48 hours

2. The transfer sensitivity level is deflecting appointment calls before transferring

If a surgery's transfer sensitivity is set to Level 2 or Level 3, EMMA will try multiple times to capture the patient's request before transferring. A patient calling about an appointment may experience this as EMMA going in circles rather than just putting them through.

What to do:

• Check the current transfer sensitivity level for that surgery
• Determine whether the complaint is specifically about appointment calls or about all transfer attempts
• If specifically about appointments: raise a configuration change to add appointment call types to the immediate transfer bypass list for that surgery
• If about all transfers generally: discuss whether reducing the sensitivity level is appropriate

3. The patient's description was too vague for EMMA to identify an appointment intent

If a patient says something like "I just need to quickly speak to someone" or "it's a bit complicated" without mentioning appointments, EMMA cannot identify the appointment intent and will handle the call through the standard deflection flow.

What to do:

• Review the call recording to confirm what the patient said
• If the patient did not mention appointments, EMMA's behaviour was correct
• Reassure the practice that if patients mention their appointment clearly, EMMA will route them appropriately
• Consider whether the surgery would benefit from a prompt configuration that routes all vague or unspecified requests directly to reception

4. The patient wanted to book a GP or nurse appointment and EMMA could not do this

EMMA cannot book appointments directly. If a patient calls to book a new GP or nurse appointment, EMMA redirects them to the NHS App or online booking system, or transfers to reception. Some practices perceive this as EMMA failing when it is actually correct behaviour.

What to do:

• Clarify to the practice that EMMA cannot book appointments in the clinical system
• Explain that EMMA's role is to capture patient requests and route them appropriately, not to act as a booking system
• If the practice wants appointment booking calls to go directly to reception without any NHS App signposting, this can be configured per surgery upon request
• Note that future Pathways functionality (coming in a future V12 update) will extend EMMA's ability to handle appointment cancellations via the NHS App

How to Request an Appointment Routing Configuration Change

To request a custom appointment routing configuration for a surgery:

1. Confirm the surgery name and ODS code
2. Confirm exactly which appointment call types should be affected, for example: cancellations only, all appointment actions, running late calls, rebook and reschedule only
3. Confirm the desired routing action: immediate transfer to reception, NHS App signposting first with transfer fallback, or a combination
4. Confirm the transfer number if different from the standard surgery number
5. Raise a prompt or configuration update request with the engineering or configuration team
6. Notify the practice once the change is live and ask them to test with a call

What to Tell the Practice

Keep communication factual and focused on the solution. Example wording when appointment calls are going through deflection:

"By default, EMMA asks a few questions before transferring calls to reception as part of how she manages call volume efficiently. However, we can configure your surgery so that appointment-related calls 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 when the complaint is about appointment booking:

"EMMA is not able to book appointments directly into the clinical system. When a patient calls to book a new appointment, EMMA redirects them to the NHS App or your online booking page, or transfers to reception. If you would prefer all new appointment booking calls to go directly to reception without any digital signposting first, we can configure that for you."

Common Mistakes

• Telling a practice that EMMA cannot be configured to immediately transfer appointment calls. It can, and several surgeries already have this configured.
• Confusing the transfer sensitivity setting with appointment-specific routing. These are separate mechanisms. Appointment call types can be added to the immediate bypass list regardless of the overall sensitivity level.
• Not reviewing the call recording before investigating. The patient's exact wording often explains why EMMA routed the call as it did.
• Not flagging to the practice that EMMA cannot book appointments directly, before promising a fix that EMMA cannot technically deliver.
• Forgetting to mention that Pathways will in future handle appointment cancellations via the NHS App as part of V12.

Escalation Guidance

Escalate to engineering if:

• A configuration change has been applied for appointment routing but EMMA is still not routing correctly after 48 hours
• EMMA is routing appointment calls incorrectly even when the patient's intent is clearly stated
• A surgery has immediate transfer configured for appointment calls and it is not being respected

When escalating, always include:

• Surgery name and ODS code
• Description of the routing behaviour expected versus what is happening
• Call IDs and timestamps for affected calls
• Whether a recent configuration change has been applied and when
• What the patient said during the call if a recording was reviewed

Last Reviewed: May 2026 Owner: Support and Customer Success