What a recall actually is #
A recall is a promise made at the end of one appointment about a future one that has not been booked. That is what makes it structurally different from every other job in a clinic. A booked appointment has a time and a person attached, so it defends itself. A recall has neither until somebody acts, which means it can be postponed indefinitely without anything appearing to go wrong.
NICE says the interval belongs to the patient, not the practice #
Dentistry is the one part of this sector with a published national position, and it is worth reading even if you are not a dentist, because it describes the shape of the problem. NICE clinical guideline CG19, last reviewed on 31 March 2020, covers intervals between oral health reviews.
The intervals CG19 sets out
It sets out the permitted intervals as 3, 6, 9 or 12 months for patients under 18, and 3, 6, 9, 12, 15, 18, 21 or 24 months for adults.
Read that as an administrative instruction and it says something awkward: a single practice wide recall period is not what the guideline describes, and a list sorted by "six months since last visit" is not a recall list, it is an approximation of one.
For physiotherapy, chiropractic, aesthetics and private GP work there is no equivalent published national interval at all. That is not a gap in this page, it is a gap in the literature, and any supplier quoting you a standard interval for those disciplines is quoting itself.
Where the rot starts #
In practice the list decays in a predictable order, and each stage looks harmless:
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The interval is recorded as a default rather than the one the clinician intended.
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The invitation is late, so the patient is already overdue when it arrives.
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The invitation goes out once, gets no reply, and is never repeated.
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A patient replies asking for a date and the reply sits unread in a shared inbox.
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Somebody books, cancels, and drops off the list entirely because they are now “booked”.
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The list grows past the point where anybody believes it, and stops being opened.
The same mechanism shows up in the account a dental practice manager gave Dentistry.co.uk on 20 September 2021: the courtesy contact her practice used to make simply stopped happening once the practice got busy, and cancellations rose. Nobody decided to stop. The work was just never protected.
Which parts run on rules #
Almost all of the bookkeeping does, because it is arithmetic on dates the practice already holds:
| The check | What it needs | Candidate? |
|---|---|---|
| Who is due this month, at their own interval | Last visit date, the interval set for that patient | Yes |
| Who was invited and has not answered | A record that the invitation was sent | Yes |
| Who is overdue by more than one interval | Dates only | Yes |
| Who has a recall set but no usable contact details | The patient record | Yes |
| What interval this patient should have | Clinical assessment of risk | No, and NICE says why |
| Whether to keep inviting somebody who never comes | Judgement about that person | No |
There is one more reason not to over engineer the sending end. The only UK study we could find that compared reminder methods head to head, Reekie and Devlin in the British Dental Journal in November 1998, found that no method outperformed another. Whether the invitation goes out matters. Which channel carries it appears not to.
Which parts do not #
- Setting the interval.
- Deciding that a patient's risk has changed.
- Deciding that somebody who has ignored four invitations should be written to differently, or not at all.
- Judging whether a long gap is neglect, a house move or something clinically worth asking about.
All of that is the practice's, and none of it is improved by being done faster. The candidates here are the admin around the care, never the care.
The privacy footnote people forget #
A recall invitation reveals that the recipient is your patient, which is information about their health and therefore special category data under UK GDPR. A lawful basis and an Article 9 condition are both needed, and your practice stays the controller whoever sends the message.
This matters more for recalls than for reminders, because a recall often goes to somebody you have not seen for a year or more, at an address or number that may no longer be private to them. The patient data page points at the ICO for the detail.
What to look at first #
Count how many patients are currently past their own recall interval, then count how many of those have ever been invited. The gap between those two numbers is the size of the problem, and it is usually a surprise.
If you want to put hours against it before speaking to anybody, the free tools use your figures rather than ours, and what the evidence says about reminders covers the sending end of the same job.