How Transfer Sensitivity Works and When EMMA Transfers to Reception

Purpose of Document

Transfer sensitivity is one of the most frequently misunderstood aspects of EMMA's configuration. Practices either complain that too many calls are going to reception, reducing the efficiency gains they expected, or that EMMA is not transferring when it should. Support staff must understand this setting thoroughly to respond accurately, adjust it when needed, and set correct expectations from go-live.

Background: What Transfer Sensitivity Is

When a patient asks to speak to reception, EMMA does not always transfer immediately. Instead, EMMA can first attempt to understand what the patient needs. Many requests that patients instinctively escalate to reception (fit notes, test results, prescription queries, referral chasing, general admin) can be handled by EMMA without a human being involved.

Transfer sensitivity controls how hard EMMA tries to capture the patient's request before transferring. It is configured per surgery and can be adjusted at any time upon request.

This setting only applies when a patient asks to speak to reception and their request is something EMMA could handle. It does not apply to calls where an immediate transfer is always required. Those scenarios are covered separately below.

The Four Sensitivity Levels

Level	Name	Behaviour	Approximate Exchanges Before Transfer	Reception Load	Efficiency
0	Instant Transfer	EMMA transfers immediately when the patient asks for reception. No encouragement.	0	Highest	Lowest
1	Low Sensitivity	EMMA gently encourages the patient to share their request using clarifying questions and reassurance approximately 3 times before transferring. Recommended for new deployments.	3	Reduced	Good
2	Medium Sensitivity	EMMA works harder to encourage the patient, varying her approach throughout the conversation approximately 5 times before transferring.	5	Lower	High
3	High Sensitivity	EMMA tries hardest to encourage the patient to share their request using multiple varied strategies approximately 7 times before transferring. Only transfers when a human is genuinely needed.	7	Lowest	Maximum

Default for new deployments: Level 1.

Most practices move to Level 2 or Level 3 within the first few weeks as they build confidence in what EMMA can handle and see the reduction in reception workload.

Calls That Always Transfer Immediately Regardless of Sensitivity Level

The following call types bypass the sensitivity setting entirely and result in an immediate transfer. These cannot be changed.

Safety and Vulnerability

Trigger	What EMMA Does
VIP or vulnerable patient matched from the uploaded VIP list	Transferred immediately to reception
Parent or carer mentions an unwell baby under 12 months	Transferred immediately to reception
Emergency red flag symptoms: chest pain, stroke symptoms, severe breathing difficulty, severe bleeding	Patient advised to call 111 or 999, then offered form capture or transfer
Suicidal ideation or self-harm	Transferred directly to surgery, not through the standard red flag advice flow
Death registration: keywords such as "passed away" or "registering a death"	Transferred immediately to reception
Digital exclusion: patient says they do not have internet or cannot use a computer	Transferred to reception

External and Professional Callers

Trigger	What EMMA Does
Hospital calling the surgery	Transferred immediately
Pharmacy calling	Transferred immediately
District nurse or community team	Transferred immediately
Health visitor or midwife	Transferred immediately
Coroner's office	Transferred immediately
Other healthcare professionals: paramedics, social workers, care homes, mental health teams	Transferred immediately
Non-healthcare organisations: solicitors, insurance companies, other agencies	Transferred immediately

Returning Calls and Reconnections

Trigger	What EMMA Does
Patient returning a missed call from the surgery	Transferred to surgery
Patient responding to an SMS from the surgery	Transferred to surgery
Call got cut off or disconnected	Transferred to surgery to reconnect
Patient chasing a callback that has not come	Transferred to surgery

Asking for a Specific Person

Trigger	What EMMA Does
Patient asks for a named doctor	Transferred to surgery. EMMA cannot route to individuals.
Patient asks for a specific staff member	Transferred to surgery
Patient asks for a pharmacist	Transferred to surgery
Patient asks for a nurse	Transferred to surgery

Capacity and Escalation

Trigger	What EMMA Does
Medical capacity reached and patient is insistent	Transferred to surgery bypass number
Red flag detected with capacity already reached	Transferred to surgery, not routed to routine flow
Patient has been through all sensitivity exchanges and still wants reception	Transferred at that point regardless of level
Home visit request	Configurable: can transfer immediately or capture as a medical request

How to Change a Surgery's Sensitivity Level

Transfer sensitivity is not self-service. It is configured by the QuantumLoop team on behalf of the practice.

To request a change:

Confirm the surgery name and ODS code
Confirm the desired sensitivity level (0, 1, 2, or 3)
Raise an internal request with the engineering or configuration team
Confirm the change with the practice once applied and ask them to monitor for 24 to 48 hours

Changes are typically applied quickly and require no downtime.

Responding to Common Practice Complaints

"Too many calls are going to reception, EMMA is not handling enough"

This is usually a sensitivity level issue. The practice is likely on Level 0 or Level 1 and would benefit from moving to Level 2 or Level 3.

What to do:

Confirm the current sensitivity level for that surgery
Explain what each level does and the expected impact on reception workload
Recommend moving to Level 2 as a starting point
Raise a configuration change request if the practice agrees
Set the expectation that most practices see a noticeable reduction in reception transfers within a few days of moving to a higher level

"EMMA is not transferring when it should, patients are going in circles"

This can mean either the sensitivity level is too high for that practice's patient demographic, or EMMA is not correctly recognising transfer-worthy triggers.

What to do:

Confirm the current sensitivity level
Review a sample of the call recordings for the affected calls
Check whether the calls involved any of the bypass triggers listed above
If the bypass triggers were present and EMMA did not transfer, escalate to engineering with the call IDs
If the calls were standard reception requests and the sensitivity level is set high, consider recommending a reduction to Level 1 or Level 2 temporarily

"Patients have figured out how to bypass EMMA by just repeatedly asking for reception"

This is expected behaviour at lower sensitivity levels. If a patient persists through all sensitivity exchanges, EMMA transfers at that point. This is by design: EMMA never completely blocks access to a human.

What to do:

Reassure the practice this is intentional and a core part of the patient safety design
Explain that the sensitivity level controls how many attempts EMMA makes before transferring
Recommend moving to a higher sensitivity level if the practice wants to reduce the number of successful bypass attempts

Step-by-Step Triage Process

Ask the practice to describe the issue precisely. Are too many calls reaching reception? Are patients complaining that EMMA is not transferring when they ask?
Check the current sensitivity level configured for that surgery.
If too many calls are reaching reception, recommend increasing the sensitivity level and raise a configuration change request.
If EMMA is not transferring when it should, review call recordings to identify which bypass triggers were involved.
If bypass triggers were present and EMMA did not transfer, escalate to engineering.
If no bypass trigger was present and the sensitivity level appears appropriate, escalate to engineering with call IDs for investigation.

What to Tell the Practice

Example wording when a practice complains about too many transfers:

"EMMA's transfer sensitivity is currently set to a lower level, which means she transfers more readily when patients ask for reception. We can increase this so EMMA tries harder to capture the patient's request before transferring. Most practices see a meaningful reduction in reception calls within a few days of adjusting this. Would you like us to make that change?"

Example wording when a practice complains EMMA is not transferring when it should:

"There are certain call types, such as emergencies, VIP patients, and professional callers, where EMMA always transfers immediately regardless of any setting. We can review the specific calls you have flagged to understand whether those triggers were present and whether EMMA responded correctly."

Common Mistakes

Telling a practice the sensitivity level cannot be changed. It can be changed at any time.
Confusing transfer sensitivity with the medical capacity bypass. These are separate mechanisms.
Not reviewing call recordings before recommending a sensitivity change.
Telling a practice that patients can never bypass EMMA. Patients who persist through all exchanges will always be transferred eventually. This is intentional.
Assuming a transfer issue is always a sensitivity level problem without first checking bypass triggers in the call recording.

Escalation Guidance

Escalate to engineering if:

EMMA is not immediately transferring calls that match a bypass trigger (VIP, emergency, professional caller, etc.)
EMMA is transferring calls that it should be handling without a transfer and the sensitivity level is confirmed high
Call recording reviews cannot explain why the transfer behaviour differs from what is expected at the configured level

When escalating, always include:

Surgery name and ODS code
Current sensitivity level
Affected call IDs and timestamps
Description of what the call recording shows
Which bypass trigger was expected if applicable

Last Reviewed: May 2026 Owner: Support and Customer Success