A gap in the diary, and nobody sure what happens next
It is 10.40 on a Tuesday. The 10.20 hygiene appointment has not turned up. Someone rings the mobile number, gets voicemail, and the slot is written off. The practice has a failed-to-attend policy on the website and on the new patient form, but whether a fee is actually charged depends on who is on reception, whether the patient is known to the team, and whether anyone remembers by the end of the day.
Two weeks later the same patient rings to rebook. The receptionist can see an FTA in the notes, but not whether it was the first or the third, or whether the dentist asked for it to be waived. So nothing is said, and the fee quietly disappears.
Why the policy never sticks
The written policy is usually fine. The problem is that applying it needs information nobody has in one place at the moment of decision: how many misses this patient has had, whether they were NHS or private for that appointment, whether the reminder actually went out, and whether a clinician has already said to let it go.
- FTAs are recorded as free text or an appointment status, so counting them per patient means scrolling through history.
- The charge is taken later, by a different person, if at all, because the patient is not in the building.
- Reception carries the awkward conversation, so the easy option is to say nothing.
- NHS and private appointments may be treated differently under your own policy, and staff are unsure which applies.
- There is no record of waivers, so the practice cannot see whether the policy is being applied fairly.
What the missed slots are costing
Each FTA is lost chair time for a dentist or hygienist whose costs do not stop. The fee, when you have one, is partly about recovering that time and partly about changing behaviour. If it is charged to some patients and not others, it does neither, and it creates complaints when a patient compares notes with a neighbour.
There is also the staff cost. Chasing an FTA fee by phone days later is one of the least liked jobs at the front desk, and it tends to drift to whoever is least busy, which in a dental practice is nobody.
The FTA process we build
- We read appointment statuses from your practice management system, such as Dentally or Software of Excellence, through its API or a scheduled export, and pick up every appointment marked as failed.
- Each FTA is written to a simple log with the patient, clinician, appointment type, whether it was NHS or private, and whether a reminder was sent and delivered.
- The patient's FTA history is counted automatically, so the rule your practice has chosen (for example a warning on the first miss) is applied without anyone scrolling back through notes.
- A message goes to the patient by SMS or email in your wording, explaining what happens next and offering a link to rebook.
- Where your policy is to charge and the patient has a card saved with Stripe or your existing payment provider, the charge is queued for a person to approve, not taken blindly.
- Clinicians or the practice manager can mark a waiver with a reason, such as a family emergency, and that reason is kept.
- Anything unusual, such as a patient with a disputed reminder or a vulnerable patient flag, goes to an exception list rather than being charged.
| Step | Today | With the FTA process |
|---|---|---|
| Spotting the miss | Whoever notices the gap | Picked up from the diary status |
| Checking history | Scrolling notes | Count shown next to the patient |
| Telling the patient | Phone call if someone has time | Message in your wording, same day |
| Charging | Later, often forgotten | Queued for approval against a saved card |
| Waivers | Unrecorded | Logged with a reason and who approved it |
Your practice decides the policy, including how NHS appointments are handled. We implement the rules you give us and do not advise on what they should be.
A front desk that no longer has to improvise
Reception stops being the judge. When a patient rings to rebook, the screen already shows that a message went out and whether the fee is outstanding, so the conversation is short and factual. The practice manager gets a weekly view of FTAs by clinician, day and appointment type, which is often where the useful pattern is, such as first appointments of the morning or particular hygiene sessions.
Waivers stay possible, but they become visible. If one clinician waives every fee, you can see it and decide whether that is fine.
Is this your practice?
- Your FTA policy exists but staff are unsure when to apply it.
- Fees are charged by some receptionists and not others.
- Nobody can say quickly how many times a patient has failed to attend.
- Chasing FTA fees by phone is a job that keeps getting pushed back.
- You have had complaints that the policy is applied unfairly.