North East London NHS Foundation Trust (NELFT) has reported a significant reduction in missed appointments following the deployment of EBO’s AI-automated appointment management solution, with DNA (did not attend) rates falling by up to 25% and patient satisfaction reaching over 90%.
The challenge
Before the deployment, NELFT, which serves a population of approximately 4.3 million across North East London, Essex, Kent and Medway, relied heavily on phone calls and letters to manage patient bookings. Telephone lines operated only between 9am and 5pm, leaving patients with no digital route to arrange or adjust appointments outside office hours.
The result was a familiar pattern: staff spending considerable time on manual rescheduling, patients unable to cancel or rebook easily. This resulted in high rates of missed appointments. For the 0-19 health visiting service in Redbridge, DNA rates had climbed from 19% to 21% between FY2023 and FY2024, while developmental review uptake among eligible children stood at just 40%.
The solution
EBO’s AI Automated Appointment Management Solution was deployed across two early adopter services: the 0-19 Health Visiting service (initially covering one-year developmental reviews) and the Musculoskeletal (MSK) service. The solution comprises of an intelligent Virtual Assistant, surfaced on the Trust’s website, which guides patients and parents through appointment booking, rescheduling, cancellation and viewing. All this via two-way conversation, available around the clock.
Behind the scenes, the system is bi-directionally integrated with the Trust’s Rio EPR, enabling automated end-to-end workflow management without requiring manual staff intervention for routine transactions.
The solution was co-designed with frontline clinical and administrative teams, with EBO and NELFT’s transformation leads running workshops to map and redesign booking workflows before go-live.
What the data shows
Across both services, the results have been substantial.
For the 0-19 service, DNA rates dropped by 25% following the introduction of automated rescheduling in January 2025.
The financial equivalent of that improvement is estimated at £49,939 per year for nine-to-twelve-month review clinics alone, based on a cost of £140 per DNA. As a result staff were freed from inbound call handling and could instead focus on proactively contacting families who had not yet booked.
Meanwhile, developmental review uptake in the Redbridge service increased from 40% to 60%.
For the MSK service, the DNA rate fell by 20% equivalent to a saving of £119,196.
Combined across both services, the estimated yearly DNA saving is £169,135, with an additional potential efficiency saving of over £4,500 per service per year from reduced administrative handling time.
Out-of-hours access proves a significant draw
One of the more striking findings in the data is the extent to which patients and parents are using the solution outside standard working hours. For the 0-19 service, 42.7% of activity through the Virtual Assistant took place outside 9am–5pm. For MSK, the figure was 45.4%.
Staff and patient response
Patient satisfaction scores, captured at the end of each Virtual Assistant conversation, reached 90% for the 0-19 service and 91% for MSK. Patient comments highlighted ease of use and the absence of waiting times.
Staff feedback has been equally positive. Lisa London, Head of 0-19 Services at NELFT’s Redbridge service, said, “Overall, the self-booking system has enhanced our ability to deliver universal services in a way that is modern, responsive, and aligned with the needs of today’s families and in line with the guidance from the NHS 10year plan to implement digital solutions.”
David Pike, Director of clinical systems and innovations at NELFT, pointed to a broader operational benefit: “Between January and April, comparing last year to this year, we were able to offer 1,400 more appointments. That’s on top of a clear reduction in DNAs. So, not only are we saving costs by avoiding missed appointments, but we’re actually expanding access and making better use of our clinics and estates.”
What the technology comprises
EBO’s appointment management solution consists of five core components: an Intelligent Virtual Assistant; a Communications layer supporting SMS, WhatsApp, in-app messaging and voice; an Integration Hub connecting to EPRs, an Admin Portal for workflow management and conversation review; and a Business Insights module offering real-time KPI monitoring, Power BI dashboards, sentiment analysis and benefits realisation consultancy.
The virtual assistant supports over 100 languages and achieves more than 97% understanding accuracy, with a handover pathway to human staff available where needed.
What’s next
The learning from the early adopter deployments has made the solution easy to scale. In fact, it has now been rolled out to all 0-19 service teams, Children’s therapies, Adult therapies and CAMHS.
Using a Virtual Assistant as the patient interface, also provides Trusts with opportunities to further improve patient access across its diverse population by providing the service in multiple languages and using voice.
EBO’s AI Automated Appointment Management Solution is deployed across a range of NHS trusts in England and Wales. To view the full case study click here. To find out more about EBO’s Appointment Management solution click here.
