Cancellations, and the waiting-list maths
A 14:30 cancellation is worth roughly forty minutes of admin, or nothing at all, depending on one thing.
A patient cancels their 14:30. It is 11:15. Whether that slot gets filled comes down to one thing: whether somebody can find the right person to offer it to in the next few minutes.
If finding that person means scrolling a list, ringing three people and leaving two voicemails, the slot stays empty. Not because nobody tried, but because the effort exceeded the gap.
The maths
An unfilled slot costs the full value of the appointment. Filling it costs whatever the admin takes. The slot only gets filled when the second number is comfortably smaller than the first, and reception is the one making that judgement in real time, usually while doing something else.
The waiting list is not a list of names. It is a list of people ranked by how likely they are to say yes to this specific gap.
What makes a waiting list work
It has to be ordered, and the order has to be changeable. The person added first is not always the person to ring first. Somebody in pain who can come at short notice outranks somebody who has been waiting longer but can only do Saturdays.
The order has to survive. If reordering it does not stick, nobody reorders it, and it degrades back into a list of names in the order they arrived.
It has to be attached to the gap. A waiting list in a different system from the diary is a waiting list nobody opens at 11:15.
The other half: not creating the gap
Filling cancellations is the second-best outcome. The best is the appointment happening.
Most no-shows are not people deciding not to come. They are people who forgot, or who meant to rearrange and did not get round to it. A reminder that lands, on a channel they read, with an easy way to move the appointment, converts a no-show into a reschedule. A reschedule keeps the patient and frees the slot early enough to fill it properly.
What to measure
- How many cancellations get refilled, not just how many happen
- How long a slot sits open before it is offered
- How many no-shows became reschedules instead
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