Ring most Kenyan clinics at ten in the morning and the phone rings out. Not because the practice does not care, but because the person who would answer it is standing in front of a patient.
That is a structural problem, and adding a second receptionist is the expensive way to solve it.
What the calls actually are
Break a week of calls down and they fall into four groups, in roughly this order:
Appointments. Booking, moving, cancelling. Simple, frequent, and the largest group almost everywhere.
Results. “Is my test back?” Anxious callers, often ringing repeatedly because nobody told them when to expect an answer.
Accounts and insurance. Balances, claims, pre-authorisation, whether a scheme is accepted.
Clinical questions. Fewer, but the ones that genuinely need the right person and cannot wait.
Those four need different people. Routing them all to one desk is why none of them are answered well.
The first change: split the line
A menu that offers appointments, results and accounts sends each call to the people who can actually deal with it.
It is worth being careful here, because a bad menu in a healthcare setting is worse than none. Three rules:
Keep it to three or four options. Appointments, results, accounts, anything else. Not a department list.
Put the commonest first. That is almost always appointments.
Always offer a person. Someone who is unwell or worried should never be trapped in a menu. A clear route to a human on pressing nothing is essential, not optional.
The fuller guidance on writing one is here.
The second change: stop the results calls
A large share of clinic calls are people checking whether something is ready. Almost all of them can be removed.
Send a message when the result is available. One SMS removes the three calls that patient would otherwise make — and removes the calls from the people behind them in the queue too.
If results must be delivered by a clinician, send a message saying the result is ready and asking them to call at a stated time. The call still happens, but it happens when you are expecting it rather than during the morning rush.
The third change: queue instead of engaged
A patient who cannot get through does not stop needing the appointment. They either walk in — adding to the pressure at the desk — or they go to a different practice.
A queue that rings every available handset, with an honest position announcement and a callback offer when the wait is long, converts most of those lost calls into completed ones without a single extra hire.
Privacy, which matters more here
Clinics handle health information, which is sensitive personal data under the Data Protection Act 2019.
Three practical consequences:
Be careful what the menu says. A greeting that announces the name of a specialist clinic tells anybody in the room what the call is about.
Think hard before recording. If you record, know why, say so, restrict who can listen and set a short retention period. There is a policy template here. In a healthcare setting, taking proper advice is worth the cost.
Confirm who you are speaking to before discussing anything clinical. Put the verification step in the agent’s script, not in their memory.
What good looks like
A small clinic doing this well has: one number, a three-option menu, appointments handled by two people who are not also at the desk, results sent by message, and a report every Monday showing how many calls were missed and when.
That last part is what makes it improve. Most practices have never seen the number of patients who tried to reach them and could not — and it is usually the number that justifies the whole change.
The staffing arithmetic is here, and the piece on finding your busy hour is here.