The arithmetic of no-shows, and how to fix it

Work out what no-shows cost your practice each year, then the four interventions that actually move the number, ranked by how well they work.

The App14 team1 min read

The short answer

Twenty no-shows a month at a £70 slot value is £16,800 a year. That is not lost margin, it is lost revenue against fixed costs you paid anyway. For most practices it is the single largest recoverable number they have.

Work out yours

ExampleYours
No-shows per month20___
Value of a slot£70___
Monthly loss£1,400___
Annual loss£16,800___

Compare that to the one-off cost of fixing it.

The four interventions, ranked

1. Deposits. The most effective by a distance. A small refundable amount at booking filters out appointments that were never firm. Some patients will object; most practices find those were the bookings that would have been missed.

2. Reminders plus one-tap rebooking. Reminders alone help. Reminders that let someone move the appointment in one tap help far more, because the alternative to a no-show is usually a reschedule the patient could not be bothered to phone about.

3. Waiting lists that fill cancellations automatically. A slot released at 48 hours is recoverable. A slot released at 9am on the day usually is not, unless somebody is already waiting.

4. Confirmation at booking. Weakest of the four on its own, but nearly free.

Why phone reminders stopped working

Reception phoning to confirm is expensive, inconsistent, and increasingly ineffective because most people no longer answer unknown numbers.

The replacement is not more phone calls. It is putting the appointment somewhere the patient can see it and change it themselves.

Common questions

What actually reduces no-shows most?

Deposits, by a clear margin, followed by reminders and easy self-service rebooking. Reminders alone help; reminders plus a one-tap way to move the appointment help considerably more.

Won't deposits put patients off?

Some, and that is the trade. A small refundable deposit filters out the bookings that were never firm. Most practices find the filtered bookings were the ones that would have been no-shows anyway.

How do I calculate the cost?

Monthly no-shows times the value of a slot times twelve. That is the annual figure, and it is usually the largest recoverable cost a practice has.

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About the author

The App14 team · Design and engineering, Appetite Studio

App14 is the 14-day app sprint run by Appetite Studio, a London-registered design and engineering studio. We design, build, and ship production iOS and Android apps in two weeks, at a published fixed price. Everything we write here comes out of work we have actually delivered: the prices are our real prices, the timelines are our real timelines, and the limits are the ones we genuinely hold to.

Our articles are drafted with AI assistance and reviewed by the App14 team before publication. The prices, timelines, delivery record, and client outcomes described are our own.

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