How many appointments are you really losing?
Count no-shows and late cancellations separately, because they need different fixes. A no-show didn't come and didn't tell you; a late cancellation told you, but too late to fill the slot.
The sum · Alder's October
7 no-shows ÷ 46 consultations due = about 15%.
Plus 4 late cancellations, inside 24 hours.
7 no-shows × 30 minutes = 3.5 hours of Priya's consultation time with nobody in the chair.
In plain words: about one first consultation in seven was a wasted slot, and nobody had the chance to give it to someone else.
Count the slots that were due in the month, not bookings made in it. Our clinic numbers guide explains why the period matters when you compare months.
What do reminders actually change?
Reminders work, and the evidence is better than most claims you'll read. A Cochrane review of healthcare appointments found attendance of about 68% with no reminder and 79% with text reminders, similar to phone-call reminders and cheaper.
That's across many kinds of clinic, not aesthetics alone, so your numbers will differ. It does settle the first question: if you send no reminder, or one easy-to-miss email, start there.
Most no-shows aren't people who decided against you. They forgot, or their plans changed and replying looked like more effort than staying away.
Send two reminders, and make both answerable
Remind people twice: a few days before, with time to rearrange, and the day before, with a reply that reaches reception. Each reminder should say what, when, where and how to move it.
Copy and adapt · three days before, by email
"Your laser consultation at Alder Bristol is on [day] at [time], with Priya. We're on the first floor above the pharmacy. Use the blue door to the left of the pharmacy and press the Alder buzzer; there's a lift. Need a different time? Move it here: [link]. Or reply to this email and we'll sort it."
Copy and adapt · the day before, by text
"Reminder: laser consultation at Alder Bristol tomorrow at [time]. Reply 1 to confirm or 2 to move it, and we'll send you two times."
Send them from an address and number reception reads. Alder's old reminder came from a no-reply address, so the two people who answered it to say they couldn't make it reached nobody, and were counted as no-shows.
Make moving easier than missing
Put "Move" first in every reminder, because someone who moves is still a patient and someone who cancels may not be. A cancel link on its own invites people to drop out.
When someone replies "2", reception offers two times straight away, within the usual reply standard from our reply guide. A reply that sits until tomorrow becomes tomorrow's no-show.
Example · a "2" reply at Alder
Text in: "2"
Jo, within the hour: "No problem. I can do Thursday at 5.30pm or Monday at 10am. Which suits you?"
Why: two specific times are easier to answer than "when are you free?"
Give freed slots to someone who wants them
Keep a short waiting list of people who asked for a time you didn't have, and offer them any slot that frees up. At Alder, people kept asking for the 4.30pm and 5.30pm consultations, the slots that fill first.
When a "2" or a cancellation frees one of those late-afternoon slots, the first person on the list gets a message with that one time. If they don't reply within a few hours, it goes to the next.
After a no-show, send one message
Send one kind message the same day, offering to rebook, and leave it there. That's the same rule as every quiet enquiry: one useful message, or a closing note, never both. Our follow-up guide explains why.
Copy and adapt · same day
"We missed you at your consultation today. If you'd still like to come in, reply with a day that suits or book here: [link]."
Keep it free of blame and free of charges. Note the no-show on their record, so reception knows if it happens again.
Decide whether to take payment at booking
If no-shows stay high after two months of answerable reminders, take the consultation fee or a deposit when people book, refundable with notice. That's a bigger change, so try the cheaper fixes first.
Alder's rule: if first-consultation no-shows stay above 10% in December and January, it will take the £25 consultation fee at online booking, refunded with 24 hours' notice. Our treatment prices guide shows how to word a deposit or fee so nobody is surprised.
Whatever you choose, say it in the booking confirmation and in every reminder, in the same words.
Alder's finished no-show plan
Put the count, the reminders and the decision rule on one page, with a date to check.
Alder's finished no-show plan
- October: 7 no-shows from 46 first consultations due (about 15%), plus 4 late cancellations; 3.5 hours of consultation time lost
- Old reminder: one email the day before, from a no-reply address, with a cancel link only
- New reminders: email three days before with a move link; text the day before, "Reply 1 to confirm or 2 to move it"
- Replies: to reception's inbox and phone, answered within the hour in opening hours with two specific times
- Waiting list: people who asked for 4.30pm or 5.30pm get first offer of any freed late-afternoon slot
- After a no-show: one same-day message offering to rebook; no-show noted on the record
- Decision rule: if no-shows stay above 10% in December and January, take the £25 fee at online booking, refunded with 24 hours' notice
- Owner: Jo for replies and the waiting list; the clinic manager for the monthly count
Do this today
Book a test appointment for yourself and reply to the reminder you receive.
Done when: you know whether your reply reached a person, and you've written the answer on the no-show plan.
Not sure no-shows are your biggest leak? The "Find the leak" chapter of PatientPulse's free Clinic Growth Playbook follows 20 real enquiries to see where people drop out; signing up adds you to PatientPulse's emails.
Questions owners ask
Should we charge a no-show fee?
Only if it was agreed at booking, and only if you'll apply it consistently. Most clinics get further, faster, with answerable reminders and an easy way to move first.
Text or email?
Both, if you can: email has room for directions and links, and a text gets read. The day-before reminder is the one to send by text.
How far ahead should the first reminder go?
Far enough to give the slot to someone else. Three days works for most consultations; for long treatment appointments, a week.
What if the same person misses twice?
Talk to them before the next booking, kindly. A time of day may be hard for them, so offer one that suits better. If you take payment at booking, this is where that policy does its job.
Alder is an example clinic. Its figures, messages and decisions are illustrative.
