Arbol · United Kingdom
Eight o'clock.
Everyone rings at once.
Arbol answers all of them at the same time — books in your clinic diary, confirms the day before, and offers the cancelled slot to the waitlist before the morning is over.
No clinical advice · nothing migrated · flat monthly fee in GBP
Phones open
The first wave hits before anyone has finished logging in.
Every line answered in parallel. No queue forms in the first place.
AnsweredThird caller gives up
Hangs up on hold. No message left, no record created.
Booked in the diary at 08:12, with the details reception would have taken.
BookedA DNA empties a slot
Nobody has time to offer it to the waitlist before the morning runs out.
Released and offered to the waitlist in order, until someone takes it.
RefilledLunch cover
One person on reception, every line ringing.
The same agent takes all of them, and the desk keeps the person in front of it.
AnsweredShift workers ring
The answerphone takes over. That is a callback list, not access.
Answered, booked where policy allows, escalated where it does not.
BookedOne illustrative morning · behaviour is configured per practice
None of this is a manners problem
Reception is not slow. Four lines cannot be answered by one person at the same time, and the patient who never got through never became a record.
The 8am rush is a capacity problem
Patients who cannot get through at eight do not wait politely until nine. They try again, go elsewhere, or give up — and none of that shows up as a DNA.
The NHS App does not retire the practice phone
Online booking helps when slots are published. Triage-heavy demand, complex requests and people who will not use the App still land on the line your reception team has to answer.
A DNA is discovered when the clinician is already in the room
By then the slot is gone, the overhead ran anyway, and the patient who would have taken it earlier was never offered it.
After hours is not optional demand
Parents after bedtime, people who cannot leave work, anyone who rings once reception has closed. An answerphone is tomorrow's problem, not today's access.
What happens to a DNA when nobody has to make the calls
- 1Day before
Confirmed, twice
A reminder goes out by text and, if there is no reply, by voice. The patient can confirm, move or cancel by answering — no App login required.
- 2Instantly
The slot opens
The moment someone cancels, the appointment is released in the clinic diary instead of sitting in an inbox until the morning.
- 3Within minutes
The waitlist is offered it
Patients waiting for an earlier appointment are contacted in order, by message and by call, until one takes it. Your team does not dial a single number.
- 4Same day
The DNA that still happens is logged
Non-attendance is recorded with the reminder history attached, so your DNA policy and follow-up have something to stand on.
What a missed appointment costs, in NHS England's own numbers
We are not going to model your practice from a landing page. These are the published national figures, with the link to each one, so you can check them before you believe us.
- 16m
GP appointments missed in England in 2025
That is one in every 23 booked appointments — the equivalent, NHS England says, of a whole day of missed appointments at every practice in the country, every month.
NHS England, March 2026 ↗- 294k
clinical hours lost in a single month
March 2026 alone carried 1.4 million missed appointments, which NHS England put at 294,000 lost clinical hours and £65.3 million in staff time.
NHS England, March 2026 ↗- ≈£47
of staff time behind each missed appointment
£65.3m across 1.4m DNAs. It is an average, it is national, and it is the arithmetic your own DNA rate sits on top of.
Derived from the two NHS England figures above ↗
Put your own diary in
Three numbers you already have. The arithmetic is NHS England's, not ours — 12.6 minutes of clinical time and about £47 of staff time behind each missed appointment.
Your practice · per month
- Missed appointments
- 223
- Clinical hours lost
- 47
Staff time · per year
£125,000
An estimate from national averages, not a promise of recovery. It sizes the problem; the demo sizes the fix, using your phone provider's own report.
The App took the easy half. The phone kept the rest.
This is not an argument against online access — it is an argument about what is left over once online access has done its job.
Handled online
- Booking a published slot, when one is published
- Ordering a repeat prescription
- Reading a result the practice has released
- Cancelling — for the patients who signed in and remembered
Still on the line at 08:00
- Anything that needs triage before a slot can be offered
- The patient who cannot or will not use the App
- Complex, multi-part or family requests in one conversation
- The 08:00 surge itself — everyone ringing in the same six minutes
Five things worth doing this month, with or without us
If you do nothing else on this page, do these. Every one of them is free, takes under an hour, and makes any later decision — ours or somebody else's — a decision instead of a guess.
- 01
Measure the abandon rate between 08:00 and 08:30
Not the day's average — the half hour that decides the day. Your phone provider can give you calls offered, answered and abandoned by half-hour.
- 02
Count how many DNAs had a confirmation attempt
Split last month's DNAs into confirmed / not confirmed. The gap is the part a reminder-and-offer loop can actually move.
- 03
Write down the waitlist rule you already use informally
Who gets offered a released slot, in what order, and how long they have to answer. If it lives in one receptionist's head, it stops when they are on leave.
- 04
Agree the escalation wording with a clinician
One page: what an urgent-sounding call gets told, where it is directed, and who is alerted. Any agent — human or otherwise — should read the same script.
- 05
Name the owner of the callback list
Every unanswered call becomes somebody's afternoon. If nobody owns it by name, it becomes nobody's.
An answering service, more reception hours, or an agent that finishes the job
Describes the common pattern of each category, not a specific supplier
Straight answers
Prefer email? Write tosupport@getarbol.com — a person answers.
01Does this replace the NHS App or NHS 111?
No. The App and 111 do different jobs. Arbol answers the clinic number your patients already ring and works the appointment book your practice already keeps.
02Does the agent tell patients it is not a person?
Yes, in the opening line, using your clinic's name. It also states that the call is recorded. That behaviour is not a setting an implementation can turn off.
03What happens if a caller sounds unwell or distressed?
The agent does not triage clinically and does not give clinical advice. It follows the escalation path your practice approves — directing the caller to urgent care or your on-call arrangement, and alerting your team with full context.
04Do we have to change our clinical system?
No. Arbol answers the number you already publish and books in the diary you already keep. Nothing is migrated, and your data is exportable in full.
05What does it cost?
A flat monthly fee in GBP, sized to your call volume, channels and sites — not per minute. You get the number in writing after a 30-minute call.
Live on your number in a week
Day 1
We read the phone
Half an hour on your call volume at eight, your abandon rate, your DNA rate and how far out the book runs.
Days 2–6
We train it on the practice
Appointment types, sites, clinicians, triage rules and the escalation path. You approve the wording before it takes a call.
Day 7
Live on your number
Voice and text on the line patients already ring, every conversation recorded and summarised.