An AI-powered appointment system developed by British health technology company DrDoctor could save the NHS up to £300 million a year by dramatically reducing missed hospital appointments, one of the health service’s most persistent and costly problems.
Missed outpatient appointments cost the NHS almost £1 billion a year, tying up staff time, wasting clinical capacity and extending waiting lists. DrDoctor believes its new Smart Center AI platform can reduce no-show rates by approximately 30% by predicting which patients are most likely to be a no-show and adjusting clinic capacity in advance.
The company was founded in 2012 by Tom Whicher after he repeatedly observed missed appointments while waiting in ambulances – patients arriving on the wrong day, at the wrong time or carrying outdated letters.
“Until recently we were solving parts of the problem with reminder texts, for example,” Whicher said. “But we have reached a point where we have reached a limit. AI has made something possible that would have been unthinkable five years ago.”
Launched in 2024, the Smart Center uses machine learning to assess the likelihood of a patient keeping an appointment. The system analyzes factors such as age, disadvantage indices, previous attendance behavior, demographics and the time and day of the appointment.
To create the model, DrDoctor trained its system on an anonymized dataset of four billion rows of NHS data, covering 55 million patients and 160 million appointments. A team of ten engineers spent months cleaning and validating the data before the model was deployed.
The development took around two years and was supported by a £1 million grant from the Department of Health and Social Care, paid back through a revenue share, with participating NHS organizations receiving discounted access.
The first results were remarkable. One hospital using Smart Center treated an additional 9,000 patients over a three-month period, while another was able to completely eliminate costly out-of-hours consultations.
DrDoctor estimates that if rolled out nationwide, the technology could deliver annual efficiency savings of £300 million, while significantly improving patient access to healthcare.
Convincing NHS organizations to change long-established ways of working proved as challenging as developing the technology itself. Hospitals had to adapt planning processes, retrain administrative staff and ensure patients understood the new approach.
Engineers were integrated into hospital teams to test and refine the system, working with frontline staff. “Education is just as important as technology,” Whicher said. “Without the trust of staff and patients it simply wouldn’t work.”
In addition to Smart Centre, DrDoctor has developed an AI voice agent that can handle routine patient queries, manage bookings and provide pre- and post-appointment support.
An early version of the voice system was shelved because it sounded too robotic. When the team came back to the idea six months ago, development took a quarter of the time due to advances in AI. The new version features voices with regional accents that feel more natural to patients.
“Patients become frustrated when they can’t get through on the phone and hospital staff spend a lot of time dealing with routine questions,” Whicher said. “AI is great at dealing with this and frees people up to focus on more complex cases.”
The company plans to expand the voice agent role to include medical follow-up questions and recovery support to potentially reduce unnecessary return visits to the hospital.
DrDoctor now manages more than 140 million appointments annually for 36 million patients across 70 NHS organizations, covering almost two-thirds of England. Despite posting sales of £16m in 2024, the company continues to make a loss as it continues to invest heavily in product development and NHS use.
With waiting lists under continued pressure and productivity high on the political agenda, tools that promise significant efficiency gains are attracting increasing interest. If Smart Center’s early performance is replicated across the country, AI-driven appointment management could become one of the most effective – and least controversial – digital improvements to the NHS.
